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目的:研究评价保乳治疗的效果,分析1985年—1995年111例在该院行保乳治疗患者的远期疗效。方法:111例临床Ⅰ期、Ⅱ期患者行保乳手术,术后行全乳放疗,局部缩野照射。用SAS软件分析患者年龄,肿瘤大小,组织学类型,切缘,淋巴结转移,术后放疗与复发的关系,分析切除组织量与复发率和美容效果的关系。结果:中位随访10 a,10 a复发率10 % ,转移率27 %,生存率81 %。年龄、组织学类型、淋巴结转移与复发无显著性关系(P >0.05)。肿瘤大小,切缘情况与复发有关(P <0.01)。术后未行放疗的复发率高,达75 %。60Co放疗复发率高于加速器(11 % vs 5 %)。单纯局部复发与转移无明显相关性(P >0.05)。行象限切除复发率不低于肿瘤扩大切除(P >0.05),但明显影响美容效果。结论:保乳治疗适合不同年龄、不同组织学类型的早期乳腺癌,在保证切缘阴性的前提下,扩大切除范围不提高疗效反而会影响美容效果。放疗技术的提高有助于减少复发。
OBJECTIVE: To study the effect of breast-conserving therapy and to analyze the long-term effect of 111 cases of breast-conserving treatment in this hospital from 1985 to 1995. Methods: 111 cases of clinical stage Ⅰ, Ⅱ patients underwent breast conserving surgery, postoperative whole milk radiotherapy, local shrinking irradiation. SAS software was used to analyze the relationship between age, tumor size, histological type, margins, lymph node metastasis and postoperative radiotherapy and recurrence, and to analyze the relationship between the amount of resected tissue and the recurrence rate and cosmetic effect. Results: The median follow-up 10 a, 10 a 10% recurrence rate of 27%, the survival rate of 81%. Age, histological type, lymph node metastasis and relapse no significant relationship (P> 0.05). Tumor size and margins were related to recurrence (P <0.01). Postoperative radiotherapy recurrence rate is not high, up to 75%. 60Co radiotherapy recurrence rate was higher than the accelerator (11% vs 5%). There was no significant correlation between simple local recurrence and metastasis (P> 0.05). Line quadrant resection recurrence rate of not less than tumor expansion and excision (P> 0.05), but significantly affect the cosmetic effect. Conclusion: Breast-conserving treatment is suitable for early-stage breast cancer of different ages and histological types. Under the premise of ensuring negative margins, enlarging the excision range will not affect the cosmetic effect but will improve the curative effect. Radiation therapy to help improve the reduction of recurrence.