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时间:2018-10-31
《放疗对伴腋窝淋巴结1~3个转移t1-t2期乳腺癌术后的应用价值》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、新疆区科大学硕t学位论文放疗对伴腋窝淋巴结1〜3个转移T1-T2期乳腺癌术后的应用价值姓名:谢枫申请学位级别:硕士专业:肿瘤学指导教师:木妮热.木沙江2009-04放疗对伴腋窝淋巴结1〜3个转移Ti-Tz期乳腺癌术后的应用价值研宂生:谢枫导师:木妮热.木沙江副教授摘要目的:探讨伴有腋窝淋巴结1〜3个转移T1-T2期乳腺癌根治术后接受区域淋巴结放疗后的淋巴结复发率和胸壁复发率,分析腋窝淋巴结转移率与复发率的相互关系。方法:回顾分析82例中位年龄44岁(28-65岁),根治术或改良根治术清扫腋窝淋巴结中位数11个(1一21个),淋巴结转移率中位值为16.67%(5.26-100%)。术
2、后行同侧锁骨上、内乳、腋窝淋巴引流区放疗,总剂量50Gy/25次。结果:中位随访86月(96-156月),3年及5年总生存率分别为90.1%和75.6%。总5年淋巴结复发率和胸壁复发率分别为12.19%和9.76%。淋巴结转移率<20%和^20%的5年淋巴结复发率和胸壁复发率分别为5.88%vs22.58%(P=0.031)和3.92%vsl9.35%(P=0.03).多因素分析显示:淋巴结转移率是总复发率的独立预后因素,淋巴结转移率、化疗<4周期是总生存率的预后因素。结论:术后伴腋窝淋巴结1〜3个转移T.-T2期乳腺癌患者中,淋巴结转移率220%伴T2期胸壁复发率较高,需考虑术后
3、淋巴引流区域和胸壁放疗。关键词:乳腺肿瘤/放射治疗;术后放疗预后ValueofpastmastectomyradiotherapyinT1orT2breastcancerpatientswith1-3postitiveaxillarylymphnodesPostgraduate:XIEFengSupervisor:Associateprof.munire.mushajiangAbstractObjective:Toanalyzetheincidenceandriskfactorsforregionalnodalfailture(RNF)inT1orT2breastcancerpat
4、ients(median44year-range28-65)with1-3positiveaxillarynodestreatedwithpostmastectomyradiotherapylimitedtotheregionalnodes.Methods:From1995to2000,82patientsweretreatedwithpastmastectomy(radicalormodifiedradical)radiotherapyconfinedtothesupraclavicular、internalmammaryandaxillarylymphnodeswithamed
5、iandoseof50Gyin25fractionsover5weeks.Themediannumberofnodesexaminedwas11(range1-21).Themedianlymphnodsrate(LNR)was16.67%(range5.26%-100%).Results:The5-yearoverallsurvivalratewas90.1%and75.6%,respectively.The5-yearRNFandCWRwas12.19%and9.76%,respectively.The5-yearRNFinpatientswithLNR<20%and>20%w
6、as5.88%and22.58%(P=0.031).The5-yearCWRinthesubgroupswithLNR<20%and>20%was3.92%and19.35%(P=0.03)丄NRwastheonlyindependentprognosticfactorforRNF+CWR,LNRandchemotherapylessthanfourcyclesweretheindependentprognosticfactorforoverallsurvivalratebymultivariateanalysis.Conclusion:InT1orT2breastcancerpa
7、tientswith1-3positiveaxillarynodestreatedwithradicalormodifiedradicalmastectomy,arelativelyhighincidenceofchcastwallrecurrenceisobservedinthesubgroup.Lymphnodesrateistheonlysignificantprognosticfactoroflymphnodsandchestwallrecurrence.Fo
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