Treatment progress of local recurrence of breast cancer

陈佳艺

doi:10.3969/j.issn.1007-3969.2013.08.006

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Treatment progress of local recurrence of breast cancer

更新时间：2025-12-31

- Treatment progress of local recurrence of breast cancer
- China Oncology Vol. 23, Issue 8, Pages: 596-602(2013)
- 作者机构：
  
  复旦大学附属肿瘤医院放疗科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2013.08.006
  CLC：
- Published Online：26 February 2014，
  
  Published：2013
- 稿件说明：
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陈佳艺. 局部区域复发乳腺癌的治疗进展[J]. 中国癌症杂志, 2013, 23(8): 596-602.

陈佳艺. Treatment progress of local recurrence of breast cancer[J]. China Oncology, 2013, 23(8): 596-602.
陈佳艺. 局部区域复发乳腺癌的治疗进展[J]. 中国癌症杂志, 2013, 23(8): 596-602. DOI： 10.3969/j.issn.1007-3969.2013.08.006.

陈佳艺. Treatment progress of local recurrence of breast cancer[J]. China Oncology, 2013, 23(8): 596-602. DOI： 10.3969/j.issn.1007-3969.2013.08.006.

摘要

和初治的乳腺癌相比，局部区域复发性患者的预后分析和挽救治疗策略选择存在更多的不确定性。本文首先分析了影响保乳手术和乳房切除术后局部-区域复发的高危因素以及相应的复发模式。以再次手术和包括完整复发灶及相应亚临床病灶的放射治疗为主要形式的局部治疗是综合治疗策略的基础，合理的局部治疗可以达到有效的局部疾病控制率并降低二次局部区域复发。虽然既往的前瞻性或回顾性资料对于全身治疗在局部-区域复发乳腺癌治疗中的价值始终没有确认，由多个国际乳腺癌研究组织联合发起的CALOR研究结果的公布第一次证实，在保留合理的内分泌治疗和靶向治疗的前提下，手术+放射治疗联合后续的全身化疗可以进一步提高无病生存率和总生存率，尤其在激素受体阴性的患者中获益更显著。所以结合原发病灶和复发灶的肿瘤标志物给予合理的全身治疗将成为局部区域复发患者综合治疗重要的组成部分。

Abstract

Compared with initial treatment of primary breast cancer

more uncertainties exist regarding to the prognosis and salvage therapy of local-regional recurrent breast cancer. This article summarized the pattern of recurrence after breast conservative therapy and mastectomy respectively. Comprehensive local treatment comprising re-excision and entire-field radiotherapy are the mainstay of multi-disciplinary treatment. Optimized local treatment is efficient not only in local disease control but also in preventing subsequent recurrence. Although past data did not fully justify the role of systemic treatment in local-regional recurrent patients

the result of CALOR trial

which was initiated by several international breast cancer co-operative groups has confirmed that based on individualized endocrine and targeted therapy

salvage surgery plus radiotherapy followed by systemic chemotherapy improved the disease-free survival and overall survival compared to surgery + radiotherapy alone

especially in estrogen receptor negative patients. Thus

systemic treatment based on biomarkers from primary as well as recurrent disease will become an integrated part in the therapeutic strategy of local-regional recurrent breast cancer.

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