Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France.
Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France.
Ann Oncol. 2011 Jan;22(1):9-16. doi: 10.1093/annonc/mdq301. Epub 2010 Jun 7.
Data from the Surveillance, Epidemiology, and End Results program and the European Concerted Action on survival and Care of Cancer Patients (EUROCARE) project indicate that approximately 6% of women newly diagnosed with breast cancer have stage IV disease, representing approximately 12 600 new cases per year in the United States in 2005. Historically, local therapy of the primary tumor in this setting has been aimed solely at symptom palliation. However, several studies suggest that surgical excision or exclusive irradiation of the primary tumor can prolong these patients' survival. In contrast, the impact of surgical dissection of regional lymph nodes and postoperative radiotherapy is poorly documented, and the patient subgroups most likely to benefit from treatment of the primary tumor remain to be identified. Two prospective studies are currently examining the benefits of locoregional therapy compared with systemic therapy alone in this setting. Here, we discuss current issues regarding treatment of the primary tumor in breast cancer patients with synchronous metastases.
来自监测、流行病学和最终结果计划（Surveillance, Epidemiology, and End Results program）和欧洲癌症患者生存和护理协同行动（European Concerted Action on survival and Care of Cancer Patients，EUROCARE）项目的数据表明，大约有 6%的新诊断乳腺癌女性患有 IV 期疾病，这代表了 2005 年美国每年大约有 12600 例新发病例。从历史上看，这种情况下原发性肿瘤的局部治疗仅仅是为了缓解症状。然而，几项研究表明，对原发性肿瘤进行手术切除或单纯放疗可以延长这些患者的生存时间。相比之下，手术切除区域淋巴结和术后放疗的影响记录不佳，并且最有可能从治疗原发性肿瘤中获益的患者亚组仍有待确定。目前正在进行两项前瞻性研究，以比较局部区域治疗与单纯全身治疗在这种情况下的益处。在这里，我们讨论了目前在同步转移的乳腺癌患者中治疗原发性肿瘤的相关问题。
