The Long-term Efficacy Observation of Whole-breast External Beam Radiation Therapy after Breast Conserving Surgery Coupled with Brachytherapy or Local Electronic Boost Radiation / 昆明医科大学学报

ABSTRACT

Objective To summarize the long term effect of the whole-breast external beam radiation therapy after breast conserving surgery coupled with brachytherapy or local electronic boost radiation. Methods The survival rate and cosmetic results were retrospectively analyzed for 96 patients with early stage breast cancer received breast conserving surgery and hormone therapy from January 1995 to December 2003 in Yunnan Tumor Hospital. The enrolled conditions included single lesion, tumor maximum diameter ≤ 3cm, microscopically negative surgical margin, negative axillary lymph node dissection, and pathological type of invasive ductal carcinoma. 53 cases with comprehensive follow-up data were selected. Among them, 23 cases were treated with whole breast tangent conventional fractionated irradiation 46-50 G/23-25 fractions, local tumor bedarea with high dose-rate brachytherapy 8-10 Gy/1-2 fractions in postoperative,and 30 cases in control group were treated with electron beam irradiation of 10 Gy/5 fractions. The efficacy and cosmetic results were observed in every three months within two years,in every six months from three to five years, and in every year five years later. Results All the patients were followed up for 217 months (average follow-up 165 months), of which 2 patients died of distant metastasis 62 months and 158 months later after treatment. The excellent cosmetic result was more than 78%, and no local recurrence was observed in the group. The 3-,5-,10-and 15-years survival rates were 100%,100%,95.7%and 88.3%,respectively. In control group,3 patients were died of distant metastasis 46 months,97 months and 87 months later after treatment,also with excellent cosmetic results. There was only one case of local recurrence,and the local control rate was 97.0%. The 3-,5-,10-and 15-years survival rates were 100%,96.7%,93.6%and 82.3%, respectively. There was no significant difference in local recurrence and survival rates between the two groups ( >0.05) . Conclusion Both radiation brachytherapy and electronic boost have the same effect and good cosmetic results. The radiation brachytherapy shows a high quality of life and a short treatment time.