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部 —區(qū)域復(fù)發(fā)率 病例數(shù) 化療方案 局部 —區(qū)域復(fù)發(fā)率 LN+13 LN+〉 3 Recht, et al. 2022 CMF 13% 29% Katz, et al. 1031 阿霉素方案 10% 21% Wallgren, et al. 5352 不同方案 14% 24% Taghian, et al. 5758 不同方案 1927%* 13%* 2434%* 2432%* *:高分級及 LVSI 27 ? Guideline or Consensus 1. Consensus Statement on postmastectomy radiation therapy. IJROBP 1999。 44: 989. 2. Postmastectomy radiotherapy: clinical practice guidelines of the American Society of Clinical Oncology. JCO 2022。 19: 1539. 3. National Institutes of Health Consensus Development Conference Statement: adjuvant therapy for breast cancer. JNCI 2022。 93: 979. 4. EUSOMA Working Party. The curative role of radiotherapy in the treatment of operable breast cancer. Eur J Cancer 2022。 38: 196174. 5. Meeting highlights: updated international expert consensus on the primary therapy of early breast cancer. JCO 2022。 21: 335765. 6. Clinical practice guidelines for the care and treatment of breast cancer: 16,Locoregional postmastectomy radiotherapy. CMAT 2022。 170: 126373. 7. Meeting highlights: international expert consensus on the primary therapy of early breast cancer 2022. Ann Oncol 2022。 16: 156983. 上述文件均不推薦對 LN+13患者作 PMRT 28 DBCG82 bamp。C LN+13組放療療效 Overgaad M et al. Radiother Oncol 2022。82:247 ? DBCG82 bamp。c隨機(jī)分組研究: ? 入組病人: LN+和 /或 T3, T4腫瘤和 /或皮膚及 深筋膜侵犯, 總計(jì) 3083例 ? 亞組分析:淋巴結(jié)檢測總數(shù) ≥8,共 1152例 ? 治療方法:改良根治術(shù) +全身輔助治療 ? 術(shù)后放療:胸壁,內(nèi)乳,鎖骨上下 及 ? 腋窩淋巴結(jié)區(qū), 4850Gy/2225