王斌梁,刘娟,张宏伟,陈君雪,曾昭冲

• 1:复旦大学附属中山医院放疗科
• 2:复旦大学附属中山医院普通外科

摘要(Abstract)：

目的比较乳腺癌改良根治术与保留乳房综合治疗的疗效、不良反应。方法 98例改良根治术患者与99例保乳手术加放疗的患者进行比较。改良根治术患者中有49例接受术后放疗,其中8例行常规患侧锁骨上野及内乳野照射,另41例行患侧胸壁及锁骨上野照射;保乳术后皆全乳切线照射50 Gy,瘤床追加电子束照射10Gy。患侧锁骨上X线30 Gy+电子束20 Gy。结果改良根治术组有3例因多发骨转移而死亡,另有6例出现胸壁复发,2例出现锁骨上淋巴结转移,1例出现腋下淋巴结转移,胸骨和肺转移各1例;保乳组有1例随访14月时因多发骨转移死亡,余患者均无复发。两组的总生存时间差异无统计学意义(P=0.234),但无瘤生存时间保乳组要优于改良根治术组(P<0.001)。保乳组患者的放疗不良反应中,84.6%为Ⅰ级反应,14.5%为Ⅱ级反应,仅1例出现Ⅲ级迟发性毒性反应。无皮肤、软组织坏死、乳房及上肢水肿等并发症。美容效果达到优83例(83.8%),良4例(4.0%),一般12例(12.1%)。满意率(优+良)87.9%。结论与改良根治术比较,保乳综合疗法安全、可靠,美容效果满意,并发症发生率低,可保全患者的生理功能和社会心理状态,提高其生活质量。

关键词(KeyWords)： 乳腺肿瘤/外科学;回顾性研究;乳房切除术,改良根治性;综合疗法;乳腺肿瘤/放射疗法;随访研究;治疗结果

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王斌梁,刘娟,张宏伟,陈君雪,曾昭冲

DOI: 10.13267/j.cnki.syzlzz.2011.04.003

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