Clinical Research Of Conservative Surgery Plus Radiation Therapy In Early-stage Breast Cancer Patients

Objective:To research the clinical therapeutic effects, side reactions and cosmetic results in early-stage breast cancer patients treated with conservative surgery plus radiation therapy.Methods:Retrospectively analyzing 69 women patients of early-stage breast cancer received conservative surgery plus post-operative radiotherapy in First Affiliated Hospital Of Dalian Medical University from September 2004 to October 2009. There were 44 patients in stage I,25 patients in stage II. All of the patients received conservative surgery combined with axillary lymph node dissection. The postoperativeradiotherapy consisted of whole-breast 6MV X-ray with two tangential fields to a total dose of 46-50Gy, followed by a boost irradiation to the tumor bed for 10-14Gy in 6MeV or 9MeV electron beam. Patients with axilla lymph metastasis still received supraclavicular field irradiation for 50Gy in X-ray and electron beam. Dose volume histograms(DVH) were used to evaluate the dosage of target volume and normal tissues. Side reactions of radiation therapy were estimated according to the standard of RTOG/EORTC. The breast cosmetic effects were evaluated by the method of Harris'standard. The disease-free survival and overall survival were calculated by the method of Kaplan-Meier.Results:The follow-up period was from the end of radiotherapy to March 31,2010. The median follow-up period was 33 months (6-67 months). The follow-up rate was 100%. One patient died of the brain metastasis. One patient died because of the bone and lung metastasis. Another patient happened supraclavicular lymph metastasis on the diseased side, who was alive until the end of follow-up. Dosage estimate:the V95% of target volume was 96.63%; the V2o of trouble side lung was 17.00%; the V30 of heart was 3.44%; the max dose of spinal was 0.64Gy. Side effects of radiotherapy:61 patients (88.4%) of radioactive skin injury were grade I, which mainly showed erythema, hyperpigmentation and dry desquamation; 8 patients (11.6%) of radioactive skin injury were gradeâ…¡, mainly showed moist desquamation in the fold position; the gradeâ…¢andâ…£skin injury were not found; 2 patients (2.9%) experienced radioactive pulmonitis of gradeâ… ; the complication, such as heart injury, skin fibration, telangiectasia, breast and upper limb edema, did not occur. Breast cosmetic evaluation:the evaluate results, beginning from 12 months after breast-conserving surgery, showed that the rate of over fair outcomes was 92.8%, and the rate of general was 7.2%; no one was bad. Survival conditions:the 1 and 3-year disease-free survival rate and overall survival rate were both 100%,5-year of these were 88.2% and 93.1%,5-year local control rate was 100%.Conclusions:1. In early-stage breast cancer patients treated with conservative surgery plus radiation therapy, the results of local control rate, disease-free survival and overall survival are satisfactory.2. The incidences of radiotherapy side effects are low, and patients can tolerate these side effects.3. Patients receiving breast-conserving therapy have good cosmetic results and high quality of life.4. For clinical stage â… andâ…¡breast carcinoma, breast-conserving therapy is recommended, if the indication of breast-conserving therapy can be mastered strictly.5. Breast-conserving therapy influencing on forward cosmetic effects and quality of survival still need further discuss and abserve.