[Therapeutic efficacy of postoperative irradiation on carcinoma of the breast].

Nihon Gan Chiryo Gakkai shi Pub Date : 1990-06-20
S Mikuriya, K Konoeda, K Hatano, T Shiina
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Abstract

From July 1973 to October 1983, 77 patients received mastectomy followed by postoperative irradiation at National Medical Center Hospital. The patients were classified as follows: 9 cases as stage I, 30 cases as stage II, 28 cases as stage IIIa, 7 cases as stage IIIb and 2 cases as stage IV. Irradiation fields were the parasternal and supraclavicular region. The axis of the irradiation fields to parasternal and supraclavicular regions were set up at 3.5 cm from the surface of the body and they were irradiated separately. The irradiation fields were about 0.5 cm apart from each other. Parasternal region contained bilateral parasternal lymphnodes. In some cases, the centersplit was used to prevent the radiation myelopathy. Prophylactic irradiation to axilla was performed by electron beam from October 1974 to September 1977. Prophylactic irradiation to chest wall has not been done since 1973. The five and ten years survival rates of stage II were 93.2% and 86.3%, stage IIIa were 61.9% and 55. 7%, Stage IIIb were 71.4% and 35.7%. The rate of the local recurrence at the supraclavicular region was 0% as stage I, 6.7% as stage II, 0% as stage IIIa and 14.3% as stage IIIb. Among the cases with regional lymphnode involvement at the time of mastectomy, the rate of local recurrence at the supraclavicular region was 6.7% in prophylactic irradiation group and it was significantly lower than in non-prophylactic irradiation group (11.5%) (p less than 0.05). The rate of local recurrence to chest wall was 0% as stage I, 6.7% as stage II, 8.0% as stage IIIa and 42.9% as stage IIIb.(ABSTRACT TRUNCATED AT 250 WORDS)

[乳腺癌术后放疗的疗效分析]。
从1973年7月至1983年10月,77例患者在国立医学中心医院接受乳房切除术和术后放射治疗。患者分为:I期9例,II期30例,IIIa期28例,IIIb期7例,IV期2例。照射部位为胸骨旁和锁骨上区。胸骨旁区和锁骨上区的照射场轴距体表3.5 cm,分别照射。辐照场间距约为0.5 cm。胸骨旁区包含双侧胸骨旁淋巴结。在一些病例中,中心裂被用来预防放射性脊髓病。1974年10月至1977年9月,采用电子束对腋窝进行预防性照射。自1973年以来,对胸壁的预防性照射就没有进行过。ⅱ期5年和10年生存率分别为93.2%和86.3%,IIIa期为61.9%和55%。IIIb期分别为71.4%和35.7%。锁骨上区局部复发率为I期0%,II期6.7%,IIIa期0%,IIIb期14.3%。在乳房切除术时局部淋巴结受累者中,预防放疗组锁骨上区局部复发率为6.7%,显著低于非预防放疗组的11.5% (p < 0.05)。胸壁局部复发率I期为0%,II期为6.7%,IIIa期为8.0%,IIIb期为42.9%。(摘要删节250字)
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