目的：本研究的目的在於探討局部復發之乳房腫瘤病患接受放射線治療後的成果。材料與方法：自1989年10月至2000年12月，共有63位有局部復發之乳房腫瘤病患納入本篇研究。根據AJCC 6th，2002的分期，有4位Stag Ⅰ，8位Stage Ⅱa，22位stageⅡb，23位stage Ⅲa，6位Stage Ⅲb。局部復發的部位有40位在同側胸壁，16位在腋窩及22位在鎖骨上窩。這些患者接受的治療方式有electron beam和combined photon-electron beam。治療的中值劑量為60Gy（分佈範圍40-66Gy）。統計overall survival (OS)，disease free survival (DFS)，locore-gional free Survival (LRFS)及由distant metastasis free survival (DMFS)的差異是藉由Kaplan-Meier method (Log-rank test)作比較。另外多變相分析是藉由Cox regression model完成。結果：追蹤時間的中位數為36個月（分佈範圍3-93個月）。有35位病患(55.6%)最終發生遠處轉移，最常發生的部位為肺(41.7%)及骨(44.4%)。三年OS為54%，三年DFS為31.7%，三年LRFS爲50.8%，三年DMFS為34.9%。三年OS在單一部位及多部位復發患者分別為60.4%和20%(p=0.02)。三年OS在較小的復發腫瘤(<=3cm）及較大／多發性復發腫瘤患者分別為71.9%和35.5%(p<0.01)。三年OS在原發疾病無合併淋巴結轉移及合併淋巴結轉移病患分別為78.6%和46.9%(p=0.04)。三年OS對於疾病復發與原發之間隔時間較長（>24個月）及較短的患者分別為81.5%和33.3%(p<0.01)。此外，三年OS在接受手術治療及無接受手術治療的病患分別為63.8%和25%(p<0.01)。結論：放射線治療對於初期且無淋巴結轉移患者能夠提供良好的局部控制。對於有多發性或體積較大的腫瘤，或者是併有淋巴結轉移的患者，則需更進一步的積極治療方式以達到更好的疾病控制。

Purpose: This study aimed to investigate the outcome of salvage radiotherapy for post-mastectomy breast cancer patients with locoregional recurrence (LRR). Materials and Methods: This study comprised 63 patients who completed allocated radiation treatment for LRR after mastectomy from October 1989 to December 2000. The distribution of initial American Joint Committee on Cancer (AJCC) 6th staging, 2002, included 4 stage I patients, 8 stage ha patients, 22 stage IIb patients, 23 stage IIIa patients, and 6 stage IIIb patients. The recurrent sites (including 40 in the ipsilateral chest wall, 16 in the axillary fossa, and 22 in the supraclavicular fossa) were treated with either electron beam or combined photon-electron beam therapy. The median prescribed dose was 60 Gy (range, 40-66 Gy). The overall survival (OS), disease free survival (DFS), locoregional free survival (LRFS), and distant metastasis free survival (DMFS) rates were compared by Kaplan-Meier method (Log-rank test); Cox regression model was used for a multivariate analysis. Results: After a median follow-up of 36 months (range, 3-93 months), 35 patients (55.6%) had developed distant metastasis at the time of the most recent follow-up. The most common sites were lung (41.7%) and bone (44.4%). The 3-year OS rate was 54%. The overall 3-year DFS rate was 31.7%. The overall 3-year LRFS rate was 50.8%. The overall 3-year DMFS rate was 34.9%. The 3-year OS for single site and multiple site recurrence was 60.4% and 20% (p=0.02), while the 3-year OS for small recurrent tumor (<=3cm) and large tumor/multiple lesions was 71.9% and 35.5%, respectively (p<0.01). Analysis of initial nodal status revealed that the 3-year OS for patients with no node metastasis was 78.6% and that for patients with positive node metastasis was 46.9% (p=0.04). In addition, the 3-year OS for patients with long latent period (>24 months) and short latent period was 81.5% and 33.3% (p<0.01), respectively. The 3-year OS for patients with and without surgery for recurrent tumor was 63.8% and 25% (p<0.01), respectively. Conclusion: Salvage radiotherapy is effective in achieving satisfactory local control in patients with early stage disease and no lymph node metastasis who developed LRR. For patients with multiple or large recurrent tumors, as well as advanced initial lymph node metastasis, it is imperative to incorporate more aggressive systemic treatment to improve treatment outcome.