Bilateral breast-conserving therapy for bilateral breast cancer: Results and consideration of radiation technique
Bilateral breast-conserving therapy for bilateral breast cancer: Results and consideration of radiation technique
复制标题
双侧乳腺癌的双侧保乳治疗：放射技术的结果和考虑
作者：
Chikako Yamauchi;M. Mitsumori;Y. Nagata;M. Kokubo;T. Inamoto;K. Mise;H. Kodama;M. Hiraoka
背景：虽然保乳手术后的明确放射治疗是早期乳腺癌患者的既定治疗方法，但保乳治疗（BCT）在双侧乳腺癌患者中的作用尚未得到很好的研究，放射治疗技术仍在研究中。我们研究了双侧乳腺癌保乳治疗的可行性，并在此介绍了我们的CT模拟器放射治疗技术。方法在1990年7月至1998年12月间，我们对17例双侧乳腺癌患者行双侧保乳手术，并行明确放射治疗。同步双侧乳腺癌7例，异时双侧乳腺癌10例。除1例患者外，所有患者的双侧全乳放射治疗均为50 Gy。所有患者均使用CT模拟器规划乳房切向辐射场。对8个边缘闭合或边缘阳性的肿瘤进行10 Gy的增强照射。结果每次手术后中位随访时间为95个月，无患者出现两侧局部复发，无远处转移。此外，未观察到严重的晚期不良反应。结论BCT对双侧乳腺癌的诊断是可行的，CT模拟器对确定双侧乳腺癌的辐射场是有用的，特别是当病变是同步的时候。
BackgroundAlthough breast-conserving surgery followed by definitive irradiation is an established treatment for patients with early breast cancer, the role of breast-conserving therapy (BCT) for patients with bilateral breast cancer has not been well studied and the radiation therapy technique is still under investigation. We examined the feasibility of breast-conserving therapy for bilateral breast cancer and present here our radiation therapy technique with CT simulator.MethodsBetween July 1990 and December 1998, we treated 17 patients with bilateral breast cancer who underwent bilateral breast-conserving surgery followed by definitive irradiation. Seven patients had synchronous bilateral breast cancer and ten had metachronous bilateral breast cancer. Radiation therapy consisted of 50 Gy to the bilateral whole breast in all patients but one. A CT simulator was used to plan a tangential radiation field to the breast in all patients. Boost irradiation of 10 Gy was administered to 8 tumors with close or positive margins.ResultsWith a median follow-up periods of 95 months from each operation, no patients showed locoregional recurrence on either side, and none suffered distant metastasis. Furthermore no serious late adverse effects were observed.ConclusionThis study demonstrated that BCT is feasible for bilateral breast cancer and the CT simulator is useful for determining the radiation field, especialy when lesions are metachronous.