Radiotherapeutic Management of Isolated Loco-Regional Recurrence of Breast Cancer after Mastectomy.
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概要
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Between August 1961 and October 1993, 126 patients (143 lesions) with isolated locoregional recurrence of breast cancer after mastectomy were treated with elective radiotherapy. The most common site of involvement was the chest wall (nodular type; 49 lesions, invasive type; 17 lesions), followed by supraclavicular lymph nodes (47 lesions), axillary lymph nodes (21 lesions) and parasternal lymph nodes (9 lesions).<BR>Complete response (CR) rate for all lesions was 73%. The highest CR rate was obtained in the nodular type of chest wall involvement (84%) and the lowest was in invasive type of chest wall involvement (35%). Six recurrent lesions (6.4%) were detected within and outside of the radiation field, respectively. Failure outside of the field was frequently seen in the invasive type of chest wall involvement.<BR>With respect to the relationship between tumor response and radiation dose, 94% of the lesions were controlled using doses of 50Gy for excised lesions and 67.6% achieved CR for lesions measuring > 3cm and 68.4% for lesions ≥ 3cm at doses of 70Gy.<BR>The five-year survival for the entire group was 37%. The survival rate of patients who achieved CR (48%) was significantly better than those who did not (9%)(p>0.01). The 5-year survival rate was highest for the nodular type of chest wall involvement (76%) and the lowest was for the invasive type of chest wall involvement (24%) and supraclavicular lymph node involvement (25%).<BR>In conclusion, the usefulness of radiotherapy for loco-regional recurrence of breast cancer was confirmed. However, efforts to improve survival in the invasive type of chest wall involvement and supraclavicular lymph node involvement are required. Considering the difficulty in controlling these recurrences with radiotherapy alone, a combined modality to improve local control in the invasive type, as well as, control distant metastasis in supraclavicular lesions could offer the best possibilities.
- 一般社団法人 日本放射線腫瘍学会の論文
一般社団法人 日本放射線腫瘍学会 | 論文
- Radiotherapeutic Management of Isolated Loco-Regional Recurrence of Breast Cancer after Mastectomy.
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