Relation between time‐dose and local control of operable breast cancer treated by tumorectomy and radiotherapy or by radical radiotherapy alone
Relation between time‐dose and local control of operable breast cancer treated by tumorectomy and radiotherapy or by radical radiotherapy alone
复制标题
肿瘤切除加放疗或单独根治性放疗治疗可手术乳腺癌的时间剂量与局部控制之间的关系
作者：
MD J. P. Bataini;MD C. PICCO;MD M. MARTIN;MD R. CALLE
对67例腋窝肿瘤直径小于或等于3 cm的患者行肿瘤切除加放射治疗，122例肿瘤较大或临床阳性的患者行根治性放射治疗，未行肿瘤切除，5年后评价局部控制剂量。7~8周内7000rad的控制率为85%，而单纯根治性放疗的2/3病例则需要8000rad在8周半内控制。分别投放6000和7000rad时，腋窝亚临床病(NO，N1a)和临床病(N1b)得到了很高的控制。获得了乳腺和腋窝临床疾病的剂量反应曲线。对于亚临床疾病，没有引起这样的反应。未分化癌的复发率高于高分化癌。放射纤维化在肿瘤切除病例中并不显著，而接受根治性照射的患者中有10%的患者有乳腺纤维化。
67 patients with tumors 3 cm or less and with negative axilla, who had lumpectomy and radiotherapy, and 122 patients with larger tumors or clinically positive axilla, who had radical radiotherapy without prior lumpectomy, were evaluated at five years to determine the optimum dose for local control. 7000 rad in seven to eight weeks controlled 85% of lumpectomy cases, whereas 8000 rad in 8 1/2 weeks were required to control two‐thirds of cases treated by radical irradiation alone. Subclinical (NO, N1a) and clinical disease (N1b) in the axilla was controlled, in a very high percentage, when 6000 and 7000 rad were delivered, respectively. Dose response curves were obtained for clinical disease in the breast and axilla. No such response was elicited for subclinical disease. Undifferentiated cancers had higher recurrence rates than well differentiated tumors. Radiation fibrosis in lumpectomy cases was insignificant, whereas 10% of radically irradiated patients had fibrosis of the breast.Cancer 42:2059–2065, 1978.