Mastektomi sonrası adjuvan radyoterapi: 1494 olgunun değerlendirilmesi
Küçük Resim Yok
Tarih
2006
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Mastektomi sonrası radyoterapi uygulanan meme kanserli olgularda tedavi sonuçlarının ve prognostik faktörlerin değerlendirilmesidir. Gereç ve Yöntem: Ocak 1982-Aralık 2002 arasında adjuvan radyoterapi uyguladığımız 1494 olgu retrospektif olarak değerlendirilmiştir. Radyoterapi göğüs duvarına ve yüksek risk taşıyan olgularda bölgesel lenfatiklere 1,8-2 Gy günlük fraksiyonlarla medyan 50 Gy dozunda uygulanmıştır. Bulgular: Medyan yaşı 49 olan olguların 22'si (%1,5) evre I, 222'si (%14,9) evre IIA, 421'i (%28,2) evre IIB, 607'si (%40,6) evre IIIA, 174'ü (%11,6) evre IIIB iken 48 olgu (%3,2) Tx veya Nx olmaları nedeniyle evrelendirilememiştir. Medyan 46 aylık (aralık 6-276 ay) izlemde 73 olguda (%4,8) lokal-bölgesel yineleme, 439 olguda (%29,3) uzak metastaz saptanmış, tüm grupta 5 yıllık lokal nükssüz, hastalıksız ve genel sağkalım oranları sırasıyla %94,2, %65,5 ve %82,9 bulunmuştur. Çok değişkenli analizlerde lokal nüksü etkileyen tek prognostik faktör metastatik aksiller lenf bezi sayısı (p=0,029) iken hastalıksız sağkalımı etkileyen faktörler T evresi (p=0,042), nodal evre (p=0,041) ve metastatik aksiller lenf bezi sayısı (p=0,000); genel sağkalımı etkileyen faktörler T evresi (p=0,008), nodal evre (p=0,005), metastatik aksiller lenf bezi sayısı (p=0,001), lenf damarı invazyonu (p=0,004) ve histolojik derece (p=0,042) olarak belirlenmiştir. Sonuç: Çalışmamızda mastektomi sonrası adjuvan RT uygulanan meme kanserli olgularda tümör evresi, nodal evre, evre, metastatik aksiler lenf bezi sayısı , cilt invazyonu, lenf damarı invazyonu gibi prognostik faktörlerin lokal-bölgesel kontrol, hastalıksız ve genel sağkalımı etkilediği saptanmıştır.
Purpose: To evaluate the treatment results and the prognostic factors after postmastectomy radiotherapy in patients with breast cancer. Materials and methods: One thousand four hundred ninety four patients treated with radiotherapy after mastectomy during January 1982-December 2002 were evaluated retrospectively. Radiotherapy was applied to the chest wall and also to the regional lymphatics in patients carrying high risk factors with 1.8-2 Gy daily fractions up to the total median dose of 50 Gy. Results: Median age was 49. Twenty-two patients (1.5%) had Stage I, 222 (14.9%) had Stage IIA, 421 (28.2%) had Stage IIB, 607 (40.6%) had Stage IIIA, 174 (11.6%) had Stage IIIB disease, 48 patients (3.2%) could not be staged due to Tx or Nx status. During a median follow-up duration of 46 months (range:6-276 months) 73 patients (4.8%) developed locoregional recurrence and 439 patients (29.3%) developed distant metastases. Five-year local-recurrence-free, disease-free and overall survival rates were 94.2%, 65.5% and 82.9% respectively. In multivariate analysis the only prognostic factor influencing local control was the number of metastatic axillary lymph nodes (p=0.029) and the prognostic factors affecting disease-free survival were T stage (p=0.042), nodal stage (p=0.041) and number of metastatic axillary lymph nodes (p=0.000) and the factors influencing overall survival were T stage (p=0.008), nodal stage (p=0.005), number of metastatic axillary lymph nodes (p=0.001), lymphovascular invasion (p=0.004) and histologic grade (p=0.042). Conclusion: In the present study prognostic factors that affect loco-regional control, disease-free and overall survival after postmastectomy radiotherapy in patients with breast cancer were T stage, nodal stage, stage, the number of metastatic axillary lymph nodes, skin invasion and lymphovascular invasion.
Purpose: To evaluate the treatment results and the prognostic factors after postmastectomy radiotherapy in patients with breast cancer. Materials and methods: One thousand four hundred ninety four patients treated with radiotherapy after mastectomy during January 1982-December 2002 were evaluated retrospectively. Radiotherapy was applied to the chest wall and also to the regional lymphatics in patients carrying high risk factors with 1.8-2 Gy daily fractions up to the total median dose of 50 Gy. Results: Median age was 49. Twenty-two patients (1.5%) had Stage I, 222 (14.9%) had Stage IIA, 421 (28.2%) had Stage IIB, 607 (40.6%) had Stage IIIA, 174 (11.6%) had Stage IIIB disease, 48 patients (3.2%) could not be staged due to Tx or Nx status. During a median follow-up duration of 46 months (range:6-276 months) 73 patients (4.8%) developed locoregional recurrence and 439 patients (29.3%) developed distant metastases. Five-year local-recurrence-free, disease-free and overall survival rates were 94.2%, 65.5% and 82.9% respectively. In multivariate analysis the only prognostic factor influencing local control was the number of metastatic axillary lymph nodes (p=0.029) and the prognostic factors affecting disease-free survival were T stage (p=0.042), nodal stage (p=0.041) and number of metastatic axillary lymph nodes (p=0.000) and the factors influencing overall survival were T stage (p=0.008), nodal stage (p=0.005), number of metastatic axillary lymph nodes (p=0.001), lymphovascular invasion (p=0.004) and histologic grade (p=0.042). Conclusion: In the present study prognostic factors that affect loco-regional control, disease-free and overall survival after postmastectomy radiotherapy in patients with breast cancer were T stage, nodal stage, stage, the number of metastatic axillary lymph nodes, skin invasion and lymphovascular invasion.
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Cerrahi
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Meme Sağlığı Dergisi
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2
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2
