Department of Radiation Oncology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY 40202, USA.
Am J Clin Oncol. 2011 Jun;34(3):231-7. doi: 10.1097/COC.0b013e3181dea993.
To examine the impact of radiotherapy on breast cancer patients with triple-negative (ER-, PR-, HER2/neu-) disease.
A prospectively collected database of 152 triple negative breast cancer patients was initiated in 2004. A total of 77 patients who had all phases of their therapy (surgery, chemotherapy, and radiotherapy) at our institution with a minimum of 2-months follow-up are included. Patients with all types of surgery (lumpectomy or mastectomy), chemotherapy (neoadjuvant or adjuvant), and radiotherapy (tangents only or comprehensive nodal irradiation) are included. Patients received radiotherapy in the setting of breast-conservation and in the postmastectomy setting for ≥5 cm primary tumors and/or ≥4 positive lymph nodes. Patients were divided into 2 groups for statistical analysis, based on whether they received radiotherapy or not.
In the cohort, 53 (69%) received radiotherapy, 24 (31%) received no radiotherapy. The median follow-up was 23.2 months (range, 2.0-63.1). In the alive patients, the median follow-up time was 25.6 (range, 2.0-63.1) months. Patients who received radiotherapy were significantly more likely to be of a higher AJCC stage (P < 0.001) than patients who did not receive radiotherapy. Of the patients who received radiotherapy, 33 (61.1%) did so for breast conservation. For the entire group, 1- and 3-year overall survivals are 90.9% and 86.3%, respectively. The 3-year actuarial locoregional relapse-free survival probability for patients who received radiation was higher than those who did not receive radiation (79.6% vs. 57.9%, P = 0.049).
Despite significantly lower AJCC stage, patients with triple-negative breast cancer who do not undergo radiotherapy have a significantly higher risk of locoregional recurrence.
研究放射治疗对三阴性(ER-、PR-、HER2/neu-)乳腺癌患者的影响。
2004 年开始前瞻性收集了 152 例三阴性乳腺癌患者的数据库。共有 77 例患者在我院接受了所有治疗阶段(手术、化疗和放疗),且随访时间至少为 2 个月,符合入组条件。所有手术类型(保乳手术或乳房切除术)、化疗(新辅助或辅助)和放疗(仅切线野或综合淋巴结照射)的患者均纳入研究。保乳术和乳房切除术治疗≥5cm 原发肿瘤和/或≥4 个阳性淋巴结的患者接受放疗。为进行统计学分析,根据患者是否接受放疗,将患者分为 2 组。
在该队列中,53 例(69%)患者接受了放疗,24 例(31%)患者未接受放疗。中位随访时间为 23.2 个月(范围:2.0-63.1)。在存活患者中,中位随访时间为 25.6 个月(范围:2.0-63.1)。接受放疗的患者 AJCC 分期显著高于未接受放疗的患者(P<0.001)。在接受放疗的患者中,33 例(61.1%)为保乳治疗。对于整个组,1 年和 3 年总生存率分别为 90.9%和 86.3%。接受放疗的患者 3 年局部区域无复发生存率高于未接受放疗的患者(79.6% vs. 57.9%,P=0.049)。
尽管 AJCC 分期显著较低,但未接受放疗的三阴性乳腺癌患者局部区域复发风险显著较高。