乳腺叶状囊肉瘤40例临床分析(3)
国内马庆久等[11]报道,乳腺恶性叶状肿瘤对于瘤体较大,局部切除术切缘阳性或复发的患者辅助放疗照射乳房或胸壁可取得良好的局部控制效果,但通常乳腺恶性叶状肿瘤对放,化疗不敏感,只对少数远处转移者有一定价值,因此均不提倡术后常规行放疗,化疗治疗。但国外有学者报道[12],对乳腺恶性叶状肿瘤的患者辅助放疗照射乳房或胸壁,可取得良好的疾病局部控制效果。甚至胸壁复发者使用大剂量放疗,使病灶完全消失。笔者通过本组研究资料认为:对于瘤体较大的患者可以选择局部胸壁的放射治疗,本组9例肿瘤长径超过8 cm的全乳切除和6例局部扩大切除保留乳房的患者术后行了胸壁或患侧乳房局部“小窗”放疗,均取得满意的疗效,经过随访无一例复发或转移,预后均良好。因此我们认为:对于乳腺恶性叶状肿瘤,术后局部放疗可以提高患者的远期生存率和减少术后复发的风险。
[参考文献]
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[2] Chao TC,Lo YF Chen SC,et al. Sonographic features of phyllodes tumors of the breast[J]. Ultrasound Obstet Gynecol,2002,20(1):64-71.
[3] Parker SJ Harries SA. Phyllodes tumours[J]. Postgrad Med J 2001,77(909):428-435.
[4] 曹月敏,王国佩. 乳腺外科学[M]. 石家庄:河北科学技术出版社,1991:352-363.
[5] Reinfuss M,Mitus J,Smolak K,et al. Malignant phyllodes tumorsof the breast: A clinical and pathological analysis of 55 cases[J]. Eur J Cancer,1993,29(10):1252.
[6] Zahner J,Bassler R. The rate of mitosis in cystosarcoma pnyllodes(phyllodes tumor,WHO) of the breast. An analysis of 47 cases[J]. Gynecol Obstel,1998,246:253.
[7] Keel an PA,Myers JL,Wotd LE,et al. Phyllodes tumors:Clinicopathologic review of 60 patients and flow cytometric,analysis in 30 patients[J]. Hum Pathol,1992,23:1048-1051.
[8] Kapiris I,Nasiri N,A Hern R,et al. Outcome and predictive factors of local recurrense and distant metastases following primary surgical treatment of high grade malignant phllodes tumours of the breast[J]. Eur J Surg Oncol,2001,27(8):723-730.
[9] Khan SA,BadveS. Phyllodes tumors of the breast[J]. Curr Treat OptionsOncol,2001,2(2):139-147.
[10] Coh-cedermark G,Rulqvist LE,Rosendahl L,et al. Prognostic factors in cystosarcoma phyllodes[J]. Cancer,1991,68:2017.
[11] 马庆久,高德明.普通外科症状鉴别诊断学[M]. 北京:人民军医出版社,2005:86.
[12] Chaney AW,Pollach A McNeese MD,et al. Adjuvant radio theropy for phyllodes tumor of breast[J]. Radiat Oncol Investing,1998,6(6):264.
(收稿日期:2012-04-10 本文编辑:魏玉坡), http://www.100md.com(周韬 莫军扬 黄平 庄亚强 朱其一)
[参考文献]
[1] 沈镇宙,邵志敏. 乳腺肿瘤学[M]. 上海:上海科学技术出版社,2005:156-170.
[2] Chao TC,Lo YF Chen SC,et al. Sonographic features of phyllodes tumors of the breast[J]. Ultrasound Obstet Gynecol,2002,20(1):64-71.
[3] Parker SJ Harries SA. Phyllodes tumours[J]. Postgrad Med J 2001,77(909):428-435.
[4] 曹月敏,王国佩. 乳腺外科学[M]. 石家庄:河北科学技术出版社,1991:352-363.
[5] Reinfuss M,Mitus J,Smolak K,et al. Malignant phyllodes tumorsof the breast: A clinical and pathological analysis of 55 cases[J]. Eur J Cancer,1993,29(10):1252.
[6] Zahner J,Bassler R. The rate of mitosis in cystosarcoma pnyllodes(phyllodes tumor,WHO) of the breast. An analysis of 47 cases[J]. Gynecol Obstel,1998,246:253.
[7] Keel an PA,Myers JL,Wotd LE,et al. Phyllodes tumors:Clinicopathologic review of 60 patients and flow cytometric,analysis in 30 patients[J]. Hum Pathol,1992,23:1048-1051.
[8] Kapiris I,Nasiri N,A Hern R,et al. Outcome and predictive factors of local recurrense and distant metastases following primary surgical treatment of high grade malignant phllodes tumours of the breast[J]. Eur J Surg Oncol,2001,27(8):723-730.
[9] Khan SA,BadveS. Phyllodes tumors of the breast[J]. Curr Treat OptionsOncol,2001,2(2):139-147.
[10] Coh-cedermark G,Rulqvist LE,Rosendahl L,et al. Prognostic factors in cystosarcoma phyllodes[J]. Cancer,1991,68:2017.
[11] 马庆久,高德明.普通外科症状鉴别诊断学[M]. 北京:人民军医出版社,2005:86.
[12] Chaney AW,Pollach A McNeese MD,et al. Adjuvant radio theropy for phyllodes tumor of breast[J]. Radiat Oncol Investing,1998,6(6):264.
(收稿日期:2012-04-10 本文编辑:魏玉坡), http://www.100md.com(周韬 莫军扬 黄平 庄亚强 朱其一)