Mastektomi sonrası radyoterapi uygulanan erkek meme kanserli hasta sonuçlarımız

The results of male breast cancer patients treated with radiotherapy following mastectomy

ALi Rıza ÜÇER, Gülçin ERTAŞ, Kenan ÖZBAĞI, Hayati ABANUZ, Muzaffer Bedri ALTUNDAĞ, Durmuş Sema DÜZGÜN, Atila DEMİRKASIMOĞLU, Hakan Bekir BAKKAL, Bektaş KAYA, Tamer ÇALIKOĞLU

Özet

Ankara Onkoloji Hastanesi Radyasyon Onkolojisi Kliniği'nde Ocak 1995 ile Temmuz 2003 tarihleri arasında mastektomi sonrası radyoterapi uygulanan 12 erkek meme kanserli olgu geriye dönük olarak incelendi. Radyoterapi uyguladığımız tüm olguların %1.5'unu (12/766) oluşturuyordu. Hastaların ortalama yaşı 58 (27-74) idi. Yedi hastaya (%58) modifiye radikal mastektomi, 3 hastaya (%25) basit mastektomi, 2 hastaya (%17) radikal mastektomi uygulanmıştı. TNM evrelemesine göre evrelendirdiğimizde; 1 hasta Evre I, 1 hasta Evre IIA, 4 hasta Evre IIB, 2 hasta Evre IIIA, 4 hasta Evre IIIB idi. Postoperatif adjuvant sistemik tedavi olarak 10 hasta kemoterapi (5 hasta CMF, 5 hasta CAF/CEF), 8 hasta hormonoterapi aldı. Ortalama izlem süresi 39 ay (4-98 ay) olup; tüm hastalar hayattaydı. İki hastada göğüs duvarında lokal nüks saptandı (radyoterapiden 10 ve 33 ay sonra). Lokal nüks gelişen bir hastada aynı zamanda kemik metastazıda tespit edildi (radyoterapiden 10 ay sonra). Üç hastada kemik metastazları saptandı (radyoterapiden 24, 57, 84 ay sonra). Yedi hasta hastalıksız olarak takiptedir.

Abstract

Twelve male breast cancer patients who were diagnosed and followed between January 1995 and July 2003 in the Department of Radiation Oncology at Ankara Oncology Hospital were retrospectively analyzed. All patients received radiotherapy following mastectomy. This patient population comprises 1.5 % of all 766 breast cancer patients treated with radiotherapy during the same period. Median age was 58 (range, 27-74). Of these 12 patients, 7 (58%) patients had modified radical mastectomy, 3 (25%) patients had simple mastectomy and 2 (17%) patients had radical mastectomy. According to TNM staging system, 1 patient had stage I disease, 1 patient had stage II A disease, 4 patients had stage IIB disease, 2 patients had stage IIIA disease and 4 patients had stage IIIB disease. While 10 patients received adjuvant systemic chemotherapy ( CMF-5 patients, CAF/CEF-5 patients), 8 patients received adjuvant hormonal treatment. Median follow-up was 39 months (range, 4-98) and all patients were alive with or without disease recurrence. Two patients showed local recurrences on the chest wall at 10th and 33rd months following radiotherapy. The one who developed local recurrence 10 months following radiotherapy also had bone metastasis at the same time. Bone metastasis were observed in 3 patients at 24th, 57th and 84th months following radiotherapy. Seven patients are still recurrence free.