Harris Eleanor E R, Schultz Delray, Bertsch Helaine, Fox Kevin, Glick John, Solin Lawrence J
Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA.
Int J Radiat Oncol Biol Phys. 2003 Apr 1;55(5):1200-8. doi: 10.1016/s0360-3016(02)04201-3.
To evaluate the long-term outcome of combined modality therapy for inflammatory breast cancer.
The data from 54 women treated between 1983 and 1996 for inflammatory breast cancer were analyzed. Patients with metastatic disease or disease progression on induction chemotherapy were excluded. Induction chemotherapy was given to 52 patients. Mastectomy was performed in 52 patients. Radiotherapy was delivered to the breast or chest wall and regional lymph nodes in all patients. The median follow-up for all patients was 5.1 years.
The 5- and 10-year overall survival rate was 56% and 35%, respectively; the corresponding relapse-free survival rates were 49% and 34%. Patients with a pathologic complete response after chemotherapy with or without preoperative radiotherapy had better 5- and 10-year overall survival rates (65% and 46%, respectively) and 5- and 10-year relapse-free survival rates (59% and 50%, respectively) compared with patients without a pathologic complete response. Those patients had a 5- and 10-year relapse-free survival rate of 45% and 27%, respectively. Locoregional failure at 5 and 10 years was 8% and 19%, respectively.
The outcomes for patients completing multimodality therapy compare favorably with published data; however, the exclusion of patients with progression during induction chemotherapy may account in part for these results. The pathologic complete response rate was found to be an important prognostic factor. Selected patients with inflammatory breast cancer have the potential for long-term survival.
评估炎性乳腺癌综合治疗的长期疗效。
分析了1983年至1996年间接受治疗的54例炎性乳腺癌女性患者的数据。排除诱导化疗期间出现转移性疾病或疾病进展的患者。52例患者接受了诱导化疗。52例患者进行了乳房切除术。所有患者均接受了乳房或胸壁及区域淋巴结的放疗。所有患者的中位随访时间为5.1年。
5年和10年总生存率分别为56%和35%;相应的无复发生存率分别为49%和34%。化疗后无论有无术前放疗达到病理完全缓解的患者,其5年和10年总生存率(分别为65%和46%)以及5年和10年无复发生存率(分别为59%和50%)均优于未达到病理完全缓解的患者。未达到病理完全缓解的患者5年和10年无复发生存率分别为45%和27%。5年和10年的局部区域复发率分别为8%和19%。
完成多模式治疗的患者的疗效与已发表的数据相比具有优势;然而,诱导化疗期间排除疾病进展的患者可能部分解释了这些结果。病理完全缓解率被发现是一个重要的预后因素。部分炎性乳腺癌患者有长期生存的潜力。