CAJ | 학술논문

目的：分析早期乳腺癌保留乳房(简称保乳)手术联合术中放射治疗的近期疗效、不良反应及美容效果。方法回顾性分析解放军总医院2008年12月至2012年3月收治的75例早期乳腺癌患者行保乳手术联合术中放射治疗的临床资料。所有患者于肿瘤切除前行电子线术中放射治疗,剂量为8 Gy或15 Gy。观察术后近期治疗效果、不良反应及美容效果。采用Kaplan-Meier法计算局部复发率和生存率。结果中位随访54个月(30~66个月),2例(2．7%,2/75)患者出现术后血肿,6例(8．0%,6/75)患者出现轻微的乳腺纤维化,1例(1．3%,1/75)患者出现术后感染,16例(21．3%,16/75)患者出现1级放射性肺损伤。术后美容效果优、良率分别为57．3%(43/75)和30．7%(23/75)。患者术后3年的局部复发率为5．3%(4/75),3年的无瘤生存率为94．7%(71/75)。结论早期乳腺癌保乳手术联合术中放射治疗的近期疗效和美容效果均良好,且不良反应轻微。
목적：분석조기유선암보류유방(간칭보유)수술연합술중방사치료적근기료효、불량반응급미용효과。방법회고성분석해방군총의원2008년12월지2012년3월수치적75례조기유선암환자행보유수술연합술중방사치료적림상자료。소유환자우종류절제전행전자선술중방사치료,제량위8 Gy혹15 Gy。관찰술후근기치료효과、불량반응급미용효과。채용Kaplan-Meier법계산국부복발솔화생존솔。결과중위수방54개월(30~66개월),2례(2．7%,2/75)환자출현술후혈종,6례(8．0%,6/75)환자출현경미적유선섬유화,1례(1．3%,1/75)환자출현술후감염,16례(21．3%,16/75)환자출현1급방사성폐손상。술후미용효과우、량솔분별위57．3%(43/75)화30．7%(23/75)。환자술후3년적국부복발솔위5．3%(4/75),3년적무류생존솔위94．7%(71/75)。결론조기유선암보유수술연합술중방사치료적근기료효화미용효과균량호,차불량반응경미。
Objective To evaluate the short-term efficacy, adverse reaction and cosmetic effect of breast-conserving surgery plus intraoperative electron radiotherapy ( IOERT ) for early stage breast cancer. Methods We retrospectively analyzed the clinical data of 75 breast cancer patients who underwent breast-conserving surgery combined with IOERT in General Hospital of Chinese PLA from December 2008 to March 2013. All patients were treated with IOERT at the dosage of 8 or 15 Gy before tumor resection. The short-term efficacy, adverse reaction and cosmetic effect were evaluated after operation. Kaplan-Meier method was used to calculate the local recurrence and overall survival. Results Median follow-up period was 54 months (30-60) months. Two ( 2. 7%, 2/75 ) patients developed postoperative hematoma. Six ( 8. 0%, 6/75 ) patients developed mild breast fibrosis. One ( 1. 3%, 1/75 ) patient experienced postoperative infection. Sixteen (21. 3%, 16/75) patients developed grade 1 radiation-induced pulmonary injury. Forty-three (57. 3%, 43/75) patients had excellent cosmetic outcome and 23 (30. 7%, 23/75) had good cosmetic outcome. The 3-year local recurrence rate was 5. 3% (4/75) and the 3-year disease-free survival rate was 94. 7% (71/75). Conclusion The breast-conserving surgery combined with IOERT shows good short-term efficacy and cosmetic outcome in early stage breast cancer patients, with mild adverse reaction.