Truong Pauline T, Bernstein Vanessa, Lesperance Mary, Speers Caroline H, Olivotto Ivo A
British Columbia Cancer Agency, Vancouver Island Centre, British Columbia Cancer Agency, 2410 Lee Avenue, Victoria, BC, Canada V8R 6V5.
Am J Surg. 2006 Jun;191(6):749-55. doi: 10.1016/j.amjsurg.2005.07.028.
To evaluate the effect of radiotherapy (RT) omission on survival in older breast cancer patients treated with breast-conserving surgery.
Data were analyzed for 4836 women aged 50 to 89 with T1-T2, N0-N1, M0 breast cancer. Tumor and treatment factors, relapse rates, and overall survival (OS) and breast cancer-specific survival (BCSS) were compared between women treated with and without RT in 3 age categories: 50 to 64 (n = 2398), 65 to 74 (n = 1665), and > or = 75 years (n = 773).
Median follow-up was 7.5 years. Rates of RT omission significantly increased with advancing age (7%, 9%, and 26% in age 50-64, 65-74, and > or = 75 years respectively, P < .0001). RT omission was associated with significantly reduced local control, BCSS, and OS. Despite similar tumor characteristics and higher rates of systemic therapy use, women aged > or = 75 years were observed to have lower 5-year OS and BCSS when RT was omitted.
These findings support the hypothesis that inadequate local therapy is associated with reduced survival in elderly women treated with breast-conserving therapy.
评估保乳手术治疗的老年乳腺癌患者省略放疗（RT）对生存的影响。
分析了4836例年龄在50至89岁之间、患有T1-T2、N0-N1、M0期乳腺癌的女性的数据。比较了3个年龄组（50至64岁，n = 2398；65至74岁，n = 1665；≥75岁，n = 773）接受或未接受放疗的女性的肿瘤和治疗因素、复发率、总生存率（OS）和乳腺癌特异性生存率（BCSS）。
中位随访时间为7.5年。省略放疗的比例随着年龄增长显著增加（50 - 64岁、65 - 74岁和≥75岁分别为7%、9%和26%，P <.0001）。省略放疗与局部控制、BCSS和OS显著降低相关。尽管肿瘤特征相似且全身治疗使用率较高，但≥75岁的女性在省略放疗时，5年OS和BCSS较低。
这些发现支持了以下假设，即局部治疗不足与接受保乳治疗的老年女性生存率降低有关。
