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目的 探讨放射治疗对腋窝淋巴结转移数≥8 个、T1 ～3 期乳腺癌的作用。方法 回顾性分析78 例行根治术的浸润性乳腺癌。术后均接受辅助化疗,疗程0.5 ～4.0 个;38 例兼接受了术后放射治疗,放射治疗部位为同侧锁骨上、下及内乳淋巴引流区,且29 例加胸壁、25 例加腋窝,放射治疗剂量45 Gy 以上占89.5 % 。结果 放射治疗组和未放射治疗组的5 年局部复发率分别为30 .8%和57.4 %( P= 0.010) ;5 年无瘤生存率分别为47 .7% 和15.7% ( P= 0 .002) ;5 年总生存率分别为64.4% 和40.6% (P= 0.083) 。做和未做胸壁足量放射治疗的胸壁复发率为7 .7 % (2/26) 和3/9 (P<0 .05)。做和未做腋窝放射治疗的腋窝复发率为4 .0% (1/25)和7 .7 % (1/13)(P> 0.05)。结论 对腋窝淋巴结转移数≥8 个、T1～3 期乳腺癌,除术后化疗外,应常规行术后放射治疗,胸壁应列为常规的照射部位之一,腋窝可不必照射
Objective To investigate the effect of radiation therapy on the number of axillary lymph node metastases ≥8 and stage T1 to stage 3 breast cancer. Methods Retrospective analysis of 78 cases of radical mastectomy invasive breast cancer. All patients received adjuvant chemotherapy with a course of 0.5 to 4.0; 38 patients were treated with postoperative radiotherapy. The radiotherapy sites consisted of ipsilateral supraclavicular, subclavian, and intramyocardial lymphatic drainage, 29 plus chest wall, and 25 armpits. Radiotherapy doses were above 85% of Gy at 45 Gy. Results The 5-year local recurrence rates in the radiotherapy and non-irradiation groups were 30.8% and 57.4 %, respectively (P = 0.010); the 5-year disease-free survival rates were 47.7% and 15.7%, respectively (P = 0. 002) ; 5-year overall survival was 64.4% and 40.6% (P = 0.083). The recurrence rate of chest wall with or without chest wall radiation therapy was 7.7 % (2/26) and 3/9 (P<0.05). The recurrence rate of axilla with or without axillary radiotherapy was 4.0% (1/25) and 7.7% (1/13) (P> 0.05). Conclusion For axillary lymph node metastasis ≥8, T1 ~ 3 breast cancer, in addition to postoperative chemotherapy, postoperative radiotherapy should be routinely performed, the chest wall should be listed as one of the routine irradiation sites, the axilla can not be irradiated