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目的 研究术前放射、化学、免疫和中医药等综合治疗对乳腺癌术后胸壁复发病人二次手术的影响和价值。方法 将6 7例患者随机分为两组。治疗组4 7例乳腺癌术后胸壁复发患者二次术前进行放疗加化疗加中医辨证治疗或化疗加局部免疫治疗加中医辨证治疗;对照组2 0例患者直接进行局部扩大切除术。术后标本分别距离肿瘤边缘1cm和2cm处进行病理检查,记录术后并发症及伤口愈合情况,进行统计学分析。结果 治疗组距离肿瘤边缘1cm和2cm处检出癌细胞情况分别为7例(15 % )和3例(6 % ) ,对照组分别为12例(6 0 % )和7例(35 % ) ,经统计学分析差异有统计学意义(P <0 .0 0 1,P <0 . 0 0 5 )。术后切口并发症治疗组13例(2 8% ) ,对照组12例(6 0 % ) ,差异有统计学意义(P <0 . 0 0 5 )。结论 乳腺癌术后胸壁复发病灶二次术前给予综合治疗可以缩小手术范围,减少切缘癌细胞残留率和术后并发症,提高局部控制率,对临床深入研究乳腺癌术后复发的防治具有重要意义。
Objective To study the effect and value of preoperative radiotherapy, chemotherapy, immunotherapy and traditional Chinese medicine on the secondary surgery of patients with chest wall recurrence after breast cancer surgery. Methods Sixty-seven patients were randomly divided into two groups. In the treatment group, 47 patients with postoperative chest wall recurrence of breast cancer underwent radiotherapy plus chemotherapy plus TCM syndrome differentiation plus chemotherapy plus local immunotherapy plus TCM syndrome differentiation. The control group of 20 patients underwent direct local enlargement resection. Postoperative specimens were 1cm and 2cm from the edge of the tumor for pathological examination, postoperative complications and wound healing were recorded for statistical analysis. Results The number of cancer cells in the treatment group was 7 cases (15%) and 3 cases (6%) at 1 cm and 2 cm from the edge of the tumor, respectively, and 12 cases (60%) and 7 cases (35% The difference was statistically significant (P <0. 001, P <0. 05). There were 13 cases (28%) in the treatment group and 12 cases (60%) in the control group, the difference was statistically significant (P <0.05). Conclusion Breast cancer recurrence of chest wall lesions after the second preoperative comprehensive treatment can reduce the scope of surgery to reduce the marginal cancer cell residual rate and postoperative complications and improve the local control rate of clinical in-depth study of the prevention and treatment of breast cancer recurrence has Significance.