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摘要目的:探讨手术、放疗、化疗在乳腺外派杰氏病（EMPD）治疗中的作用。材料与方法:报告我院3例EMPD的治疗情况，并复习1990年以来英语医学文献及国内文献中有关EMPD治疗的病例135例，合计138例。分析手术、放疗、化疗在EMPD治疗中的可行性及局限性。结果:手术组95例，切缘阳性者45例，其中单纯手术组局部复发率48.6%（18/37），行术前或术后放疗者无局部复发（0/8）；切缘阴性者50例，局部复发率26%（13/50）。单独放疗者25例，2例局部未控，3例疗后12～24月局部复发，局部控制率为80%。化疗组13例，单独化疗治愈2例，化疗+放疗治愈1例，手术+化疗治愈1例。结论:尽管手术为EMPD的首选治疗方式，但局部复发率较高，配合放疗，可降低其局部复发率，即使是单独放疗也可取得满意的局部控制效果。化疗可取得一定的疗效，但不主张作为一线治疗方案。

abstractsPurpose:The results of extramammary Paget's disease (EMPD) treated by surgery, radiotherapy and chemotherapy were analyzed.Materials and Methods:The results of 3 cases with EMPD treated in our hospital were reported, and 189 EMPD cases were reviewed 120 additional cases from English literatures since 1990, and 15 cases from domestic literatures. Treatment results by surgery, radiotherapy or chemotherapy were analyzed.Results:In surgery group 95 cases, positive surgical margins were found in 45 cases with the local recurrence rate of 40%, negative surgical margins were 50 cases, with the local recurrence rate of 26%. 8 cases in positive surgical margins were received pre or postoperative radiotherapy and no local recurrence was found. 25 cases received radiotherapy only, the local control rate was 80%. Among 23 cases of chemotherapy group, 4 cases were cured, included 2 cases of chemotherapy alone, 1 case of radiotherapy plus chemotherapy and 1 case of surgery plus chemotherapy.Conclusion:Although the recommended treatment for EMPD is surgery, surgical excision alone may exist in a high incision margins positivity and a high local recurrence rate. If it combines with postoperative radiotherapy, it can increase the local control although chemotherapy of EMPD may give effective results. Due to the short time of follow - up and small number of patients, it is not recommended to be given at the beginning of the treatment.