多柔比星为基础的新辅助化疗联合乳房切除术治疗的Ⅱ-Ⅲ期乳腺癌且年龄<35岁患者的乳房切除术后放疗效果
Effect of postmastectomy radiotherapy in patients <35 years old with stage II-III breast cancer treated with doxorubicin-based neoadjuvant chemotherapy and mastectomy.
作者信息
Garg Amit K, Oh Julia L, Oswald Mary Jane, Huang Eugene, Strom Eric A, Perkins George H, Woodward Wendy A, Yu T Kuan, Tereffe Welela, Meric-Bernstam Funda, Hahn Karin, Buchholz Thomas A
机构信息
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
出版信息
Int J Radiat Oncol Biol Phys. 2007 Dec 1;69(5):1478-83. doi: 10.1016/j.ijrobp.2007.05.029. Epub 2007 Sep 12.
Abstract
PURPOSE
Postmastectomy radiotherapy (PMRT) improves locoregional control (LRC) in patients with high-risk features after mastectomy. Young age continues to evolve as a potentially important risk factor. The objective of this study was to assess the benefits of PMRT in patients <35 years old treated with doxorubicin-based neoadjuvant chemotherapy for Stage II-III breast cancer.
PATIENTS AND METHODS
We retrospectively analyzed 107 consecutive breast cancer patients <35 years old with Stage IIA-IIIC disease treated at our institution with doxorubicin-based neoadjuvant chemotherapy and mastectomy, with or without PMRT. The treatment groups were compared in terms of LRC and overall survival.
RESULTS
Despite more advanced disease stages, the patients who received PMRT (n = 80) had greater rates of LRC (5-year rate, 88% vs. 63%, p = 0.001) and better overall survival (5-year rate, 67% vs. 48%, p = 0.03) than patients who did not receive PMRT (n = 27).
CONCLUSION
Among breast cancer patients <35 years old at diagnosis, the use of PMRT after doxorubicin-based neoadjuvant chemotherapy and mastectomy led to a statistically greater rate of LRC and overall survival compared with patients without PMRT. The benefit seen for PMRT in young patients provides valuable data to better tailor adjuvant, age-specific treatment decisions after mastectomy.
摘要
目的
乳房切除术后放疗（PMRT）可改善乳房切除术后具有高危特征患者的局部区域控制（LRC）。年轻正逐渐成为一个潜在的重要危险因素。本研究的目的是评估PMRT对接受以阿霉素为基础的新辅助化疗的II - III期乳腺癌35岁以下患者的益处。
患者与方法
我们回顾性分析了107例连续的35岁以下IIA - IIIC期乳腺癌患者，这些患者在我们机构接受了以阿霉素为基础的新辅助化疗及乳房切除术，部分接受了PMRT。比较治疗组之间的LRC和总生存率。
结果
尽管疾病分期更晚，但接受PMRT的患者（n = 80）与未接受PMRT的患者（n = 27）相比，LRC率更高（5年率，88%对63%，p = 0.001），总生存率也更好（5年率，67%对48%，p = 0.03）。
结论
在诊断时年龄小于35岁的乳腺癌患者中，与未接受PMRT的患者相比，在以阿霉素为基础的新辅助化疗和乳房切除术后使用PMRT导致LRC率和总生存率在统计学上显著更高。在年轻患者中观察到的PMRT益处为更好地制定乳房切除术后辅助性、针对年龄的治疗决策提供了有价值的数据。
相似文献
1
Effect of postmastectomy radiotherapy in patients <35 years old with stage II-III breast cancer treated with doxorubicin-based neoadjuvant chemotherapy and mastectomy.多柔比星为基础的新辅助化疗联合乳房切除术治疗的Ⅱ-Ⅲ期乳腺癌且年龄<35岁患者的乳房切除术后放疗效果
Int J Radiat Oncol Biol Phys. 2007 Dec 1;69(5):1478-83. doi: 10.1016/j.ijrobp.2007.05.029. Epub 2007 Sep 12.
2
[The role of postmastectomy radiotherapy in clinical T1-3N1M0 breast cancer patients with pathological negative lymph nodes after neoadjuvant chemotherapy and mastectomy].新辅助化疗及乳房切除术后病理淋巴结阴性的临床T1-3N1M0乳腺癌患者乳房切除术后放疗的作用
Zhonghua Zhong Liu Za Zhi. 2017 Jun 23;39(6):445-452. doi: 10.3760/cma.j.issn.0253-3766.2017.06.009.
3
Is postmastectomy radiotherapy necessary for breast cancer patients with clinically node-positive downstaging to ypN0 after neoadjuvant chemotherapy?新辅助化疗后临床淋巴结阳性降期至 ypN0 的乳腺癌患者是否需要术后放疗？
Breast Cancer Res Treat. 2024 Jul;206(1):45-56. doi: 10.1007/s10549-024-07249-2. Epub 2024 Apr 15.
4
The role of postmastectomy radiation therapy after neoadjuvant chemotherapy in clinical stage II-III breast cancer patients with pN0: a multicenter, retrospective study (KROG 12-05).新辅助化疗后临床 II-III 期 pN0 乳腺癌患者行术后放疗的作用：一项多中心回顾性研究（KROG 12-05）。
Int J Radiat Oncol Biol Phys. 2014 Jan 1;88(1):65-72. doi: 10.1016/j.ijrobp.2013.09.021. Epub 2013 Oct 22.
5
Effect of pathologic stages on postmastectomy radiation therapy in breast cancer receiving neoadjuvant chemotherapy and total mastectomy: A Cancer Database Analysis.新辅助化疗和全乳切除术后病理分期对乳腺癌术后放疗的影响：癌症数据库分析。
Breast. 2020 Dec;54:70-78. doi: 10.1016/j.breast.2020.08.017. Epub 2020 Sep 7.
6
Local-regional recurrence with and without radiation therapy after neoadjuvant chemotherapy and mastectomy for clinically staged T3N0 breast cancer.新辅助化疗和乳房切除术后 T3N0 期乳腺癌的局部区域复发伴或不伴放疗。
Int J Radiat Oncol Biol Phys. 2011 Nov 1;81(3):782-7. doi: 10.1016/j.ijrobp.2010.06.027. Epub 2011 Aug 30.
7
Impact of clinical-pathological factors on locoregional recurrence in mastectomy patients with T1-2N1 breast cancer: who can omit adjuvant radiotherapy?临床病理因素对 T1-2N1 乳腺癌改良根治术患者局部区域复发的影响：哪些患者可以省略辅助放疗？
Breast Cancer Res Treat. 2021 Nov;190(2):277-286. doi: 10.1007/s10549-021-06378-2. Epub 2021 Sep 6.
8
Radiotherapy for stage II and stage III breast cancer patients with negative lymph nodes after preoperative chemotherapy and mastectomy.术前化疗和乳房切除术后淋巴结阴性的 II 期和 III 期乳腺癌患者的放疗。
Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):e1-7. doi: 10.1016/j.ijrobp.2010.12.054. Epub 2011 Mar 4.
9
The role of postmastectomy radiotherapy in clinically node-positive, stage II-III breast cancer patients with pathological negative nodes after neoadjuvant chemotherapy: an analysis from the NCDB.新辅助化疗后病理淋巴结阴性的临床淋巴结阳性II-III期乳腺癌患者中乳房切除术后放疗的作用：来自国家癌症数据库的分析
Oncotarget. 2016 Apr 26;7(17):24848-59. doi: 10.18632/oncotarget.6664.
10
The clinical value of adjuvant radiotherapy in patients with early stage breast cancer with 1 to 3 positive lymph nodes after mastectomy.辅助放疗在乳房切除术后有1至3个阳性淋巴结的早期乳腺癌患者中的临床价值。
Chin J Cancer. 2010 Jul;29(7):668-76. doi: 10.5732/cjc.009.10744.
引用本文的文献
1
Postmastectomy Radiation Therapy: An ASTRO/ASCO/SSO Clinical Practice Guideline.乳房切除术后放射治疗：美国放射肿瘤学会/美国临床肿瘤学会/美国外科学会临床实践指南
Ann Surg Oncol. 2025 Sep 16. doi: 10.1245/s10434-025-18057-3.
2
The effect of postmastectomy radiotherapy after neoadjuvant chemotherapy in patients with breast cancer: a meta-analysis.新辅助化疗后乳腺癌患者乳房切除术后放疗的效果：一项荟萃分析。
Future Oncol. 2025 Jun;21(15):1929-1938. doi: 10.1080/14796694.2025.2505372. Epub 2025 Jun 2.
3
Post-mastectomy radiotherapy for women with early breast cancer and one to three positive lymph nodes.早期乳腺癌伴 1-3 个阳性淋巴结的女性术后放疗。
Cochrane Database Syst Rev. 2023 Jun 16;6(6):CD014463. doi: 10.1002/14651858.CD014463.pub2.
4
What Is Known about Breast Cancer in Young Women?关于年轻女性乳腺癌我们了解多少？
Cancers (Basel). 2023 Mar 22;15(6):1917. doi: 10.3390/cancers15061917.
5
The impact on clinical outcomes of post-operative radiation therapy delay after neoadjuvant chemotherapy in patients with breast cancer: A multicentric international study.新辅助化疗后乳腺癌术后放疗延迟对临床结局的影响：一项多中心国际研究。
Breast. 2020 Dec;54:46-51. doi: 10.1016/j.breast.2020.08.013. Epub 2020 Aug 29.
6
Patterns of post-operative irradiation in breast cancer patients submitted to neoadjuvant chemotherapy.接受新辅助化疗的乳腺癌患者术后放疗模式。
Rep Pract Oncol Radiother. 2019 Jan-Feb;24(1):115-123. doi: 10.1016/j.rpor.2018.11.002. Epub 2018 Nov 28.
7
Locoregional recurrence-associated factors and risk-adapted postmastectomy radiotherapy for breast cancer staged in cT1-2N0-1 after neoadjuvant chemotherapy.新辅助化疗后cT1-2N0-1期乳腺癌的局部区域复发相关因素及风险适应性乳房切除术后放疗
Cancer Manag Res. 2018 Oct 2;10:4105-4112. doi: 10.2147/CMAR.S173628. eCollection 2018.
8
Postmastectomy radiation therapy after neoadjuvant chemotherapy: review and interpretation of available data.新辅助化疗后乳房切除术后放射治疗：现有数据的综述与解读
Ther Adv Med Oncol. 2016 Jan;8(1):85-97. doi: 10.1177/1758834015617459.
9
Managing breast cancer in younger women: challenges and solutions.管理年轻女性乳腺癌：挑战与解决方案。
Breast Cancer (Dove Med Press). 2015 Dec 21;8:1-12. doi: 10.2147/BCTT.S68848. eCollection 2016.
10
The Role of Postmastectomy Radiation Therapy in Patients With Breast Cancer Responding to Neoadjuvant Chemotherapy.乳房切除术后放射治疗在对新辅助化疗有反应的乳腺癌患者中的作用。
Semin Radiat Oncol. 2016 Jan;26(1):51-8. doi: 10.1016/j.semradonc.2015.08.001. Epub 2015 Aug 29.
本文引用的文献
1
The impact of young age on locoregional recurrence after doxorubicin-based breast conservation therapy in patients 40 years old or younger: How young is "young"?40岁及以下患者接受基于阿霉素的保乳治疗后，年轻对局部区域复发的影响：多年轻才算“年轻”？
Int J Radiat Oncol Biol Phys. 2006 Aug 1;65(5):1345-52. doi: 10.1016/j.ijrobp.2006.03.028. Epub 2006 Jun 5.
2
Study of failure pattern among high-risk breast cancer patients with or without postmastectomy radiotherapy in addition to adjuvant systemic therapy: long-term results from the Danish Breast Cancer Cooperative Group DBCG 82 b and c randomized studies.除辅助性全身治疗外，对接受或未接受乳房切除术后放疗的高危乳腺癌患者失败模式的研究：丹麦乳腺癌协作组DBCG 82 b和c随机研究的长期结果
J Clin Oncol. 2006 May 20;24(15):2268-75. doi: 10.1200/JCO.2005.02.8738. Epub 2006 Apr 17.
3
Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials.早期乳腺癌放疗及手术范围差异对局部复发和15年生存率的影响：随机试验综述
Lancet. 2005 Dec 17;366(9503):2087-106. doi: 10.1016/S0140-6736(05)67887-7.
4
Selecting breast cancer patients with T1-T2 tumors and one to three positive axillary nodes at high postmastectomy locoregional recurrence risk for adjuvant radiotherapy.选择具有T1-T2肿瘤且腋窝淋巴结有1至3个阳性、保乳术后局部区域复发风险高的乳腺癌患者进行辅助放疗。
Int J Radiat Oncol Biol Phys. 2005 Apr 1;61(5):1337-47. doi: 10.1016/j.ijrobp.2004.08.009.
5
Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial.接受辅助化疗的高危乳腺癌患者的局部区域放射治疗：不列颠哥伦比亚省随机试验的20年结果。
J Natl Cancer Inst. 2005 Jan 19;97(2):116-26. doi: 10.1093/jnci/djh297.
6
Postmastectomy radiation improves local-regional control and survival for selected patients with locally advanced breast cancer treated with neoadjuvant chemotherapy and mastectomy.对于接受新辅助化疗和乳房切除术治疗的局部晚期乳腺癌特定患者，乳房切除术后放疗可改善局部区域控制并提高生存率。
J Clin Oncol. 2004 Dec 1;22(23):4691-9. doi: 10.1200/JCO.2004.11.129.
7
Patterns of locoregional failure in patients with operable breast cancer treated by mastectomy and adjuvant chemotherapy with or without tamoxifen and without radiotherapy: results from five National Surgical Adjuvant Breast and Bowel Project randomized clinical trials.接受乳房切除术及辅助化疗（使用或不使用他莫昔芬且未进行放疗）治疗的可手术乳腺癌患者的局部区域复发模式：五项国家外科辅助乳腺和肠道项目随机临床试验的结果
J Clin Oncol. 2004 Nov 1;22(21):4247-54. doi: 10.1200/JCO.2004.01.042. Epub 2004 Sep 27.
8
T3 disease at presentation or pathologic involvement of four or more lymph nodes predict for locoregional recurrence in stage II breast cancer treated with neoadjuvant chemotherapy and mastectomy without radiotherapy.新辅助化疗联合乳房切除术且未行放疗的II期乳腺癌患者，初诊时为T3期疾病或四个及以上淋巴结有病理累及提示局部区域复发。
Int J Radiat Oncol Biol Phys. 2004 May 1;59(1):138-45. doi: 10.1016/j.ijrobp.2003.10.037.
9
Locoregional failure 15 years after mastectomy in women with one to three positive axillary nodes with or without irradiation the significance of tumor size.有1至3个腋窝淋巴结阳性的女性在乳房切除术后15年的局部区域复发情况：无论是否接受放疗，肿瘤大小的意义
Strahlenther Onkol. 2003 Mar;179(3):197-202. doi: 10.1007/s00066-003-1010-7.
10
Predictive factors for local recurrence in 2006 patients with surgically resected small breast cancer.2006例接受手术切除的小乳腺癌患者局部复发的预测因素。
Ann Oncol. 2002 Sep;13(9):1404-13. doi: 10.1093/annonc/mdf227.
Zotero 插件