乳腺癌放疗进展.pptxVIP

乳腺癌放疗进展 2015-07-08保乳术后放疗保乳后放疗并非必选方案全乳腺大分割放疗的应用加速部分乳腺照射的应用手术放疗间隔与复发关系全乳照射后瘤床区域加量Background- CALGB 9343年龄≥70岁，T1N0M0，ER/PR（+），12.6年随访无局部区域复发生存无乳房切除手术生存无远处转移生存总生存PRIME-II study A phase 3, multicenters, randomised controlled trial的n＝658 WBI :40-50 Gy/15-25 fAge≥65 and undergo BCS；T1–T2 （d＜ 3 cm）N0M0； Hormone receptor(+) (ER,PR, or both); Clear excision margins (≥1 mm); Receiving adjuvant hormone treatment ；Grade 3 or LVI, but not both(permitted). R n＝668no WBIPrimary endpoint :IBTRFollow-up:10 years同侧乳腺癌复发率ResultRTno RT PIBTR(5 years):1.3%4.1%p＝0.0002HR＝5.19 p＝0.0007OS(5 years): 93.9% 93.9% p＝0.34