Radiotherapeutic management of regional lymph nodes recurrence following mastectomy
- VernacularTitle:乳腺癌根治术后区域淋巴结复发放射治疗疗效分析
- Author:
Ziqiang PAN
;
Jiayi CHEN
;
Yan FENG
- Publication Type:Journal Article
- Keywords:
breast cancer;
regional lymph nodes recurrence;
radiotherapy
- From:
China Oncology
2000;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Purpose:To investigate the prognostic factors f or local-regional control and survival in patients with regional lymph nodes re currence following mastectomy. Methods:Seventy-seven patients with their first recurrences in the regional lymph nodes treated during 1994-2003 were retrospectively analyze d. The recurrence were confined to supraclavicular region in 45 patients, in axi llary nodes in 16 patients, in internal mammary nodes in 6 patients, and with mo re than one lymph node region involved in 10 patients. The median follow-up was 34.4months. All patients were treated with radiotherapy to a total dose ranged from 50-74 Gy with a median dose of 60 Gy. Results:The median survival time was 4.67 years with 2-,5-an d 8- year survival rate of 77.8%,47.4% and 31.5% respectively. Disease-free i nterval, hormonal-receptor status were independent prognostic factors for survi val. Thirty patients had a second recurrence either in the original recurrent si te (4 patients) or in the other local-regional sites (26 patients). Chest-wall was the most frequently involved site for second recurrence, with 18 patients h ad a second recurrence including chest-wall, representing 23% of the whole coho rt. The axillary lymph nodes metastatic status of primary surgery was the only i ndependent prognostic factor for local control. Conclusions:Radiotherapy provides an efficient treatment for re gional lymph nodes recurrence following mastectomy. Twenty-three percent of pat ients present a second recurrence involving chest-wall, which suggests the sign ificance of an elective radiation to the chest-wall, especially in patients wit h 4 or more lymph nodes involved in primary surgery. Sub-group with a disease- free interval of more than 2 years, receptor positive has a better survival. The role of systemic treatment in the regional lymph nodes recurrent patients has n ot been established.
