Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France.
Radiother Oncol. 2010 Aug;96(2):199-203. doi: 10.1016/j.radonc.2010.02.028. Epub 2010 Mar 27.
Local treatments seem to improve metastasis progression-free survival (MPFS) and overall survival (OS) when added to systemic therapies in stage IV breast cancer.
From 1990 to 2003, we reviewed 9138 cases treated and registered in the Institut Gustave-Roussy breast cancer database. Among them, 308 had presented with stage IV disease. Eighty percent of patients (n=239) had received a loco-regional treatment and they were categorized into two groups: loco-regional radiotherapy (LRRT) alone (Group 1; n=147) or breast and axillary surgery+/-LRRT (Group 2; n=92).
The median follow-up was 6.5 years. LRRT obtained a long-standing loco-regional clinical response in 85% of patients. The 3-year MPFS rates were 20% in Group 1 and 39% in Group 2; the 3-year OS rates were 39% and 57%, respectively. However, no significant differences in MPFS or OS were observed between the two groups when adjusted on prognostic factors.
Radiation therapy alone provides long-standing local control and yields MPFS and OS rates equivalent to those obtained when radiation therapy is combined with surgery, whatever the prognostic factors. Loco-regional therapies, especially radiation therapy alone, may have an important role to play in the treatment of selected patients with stage IV breast cancer.
局部治疗似乎可以改善 IV 期乳腺癌患者的转移无进展生存期（MPFS）和总生存期（OS），在加入全身治疗时尤其如此。
我们回顾了 1990 年至 2003 年在 Institut Gustave-Roussy 乳腺癌数据库中接受治疗和登记的 9138 例患者。其中，308 例患者患有 IV 期疾病。80%的患者（n=239）接受了局部区域治疗，他们分为两组：单纯局部区域放疗（LRRT）（组 1；n=147）或乳房和腋窝手术+/-LRRT（组 2；n=92）。
中位随访时间为 6.5 年。LRRT 在 85%的患者中获得了长期的局部临床反应。组 1 的 3 年 MPFS 率为 20%，组 2 的 3 年 OS 率为 39%；3 年 OS 率分别为 39%和 57%。然而，在调整预后因素后，两组间的 MPFS 或 OS 无显著差异。
单纯放疗可提供长期的局部控制，并获得与放疗联合手术相似的 MPFS 和 OS 率，无论预后因素如何。局部区域治疗，尤其是单纯放疗，可能在治疗特定的 IV 期乳腺癌患者中具有重要作用。
