Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada.
Int J Radiat Oncol Biol Phys. 2013 Jul 1;86(3):491-7. doi: 10.1016/j.ijrobp.2013.02.031.
To report the outcomes of a population of women with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery and radiation and to evaluate the independent effect of boost radiation on the development of local recurrence.
All women diagnosed with DCIS and treated with breast-conserving surgery and radiation therapy in Ontario from 1994 to 2003 were identified. Treatments and outcomes were identified through administrative databases and validated by chart review. The impact of boost radiation on the development of local recurrence was determined using survival analyses.
We identified 1895 cases of DCIS that were treated by breast-conserving surgery and radiation therapy; 561 patients received boost radiation. The cumulative 10-year rate of local recurrence was 13% for women who received boost radiation and 12% for those who did not (P=.3). The 10-year local recurrence-free survival (LRFS) rate among women who did and who did not receive boost radiation was 88% and 87%, respectively (P=.27), 94% and 93% for invasive LRFS (P=.58), and was 95% and 93% for DCIS LRFS (P=.31). On multivariable analyses, boost radiation was not associated with a lower risk of local recurrence (hazard ratio = 0.82, 95% confidence interval 0.59-1.15) (P=.25).
Among a population of women treated with breast-conserving surgery and radiation for DCIS, additional (boost) radiation was not associated with a lower risk of local or invasive recurrence.
报告一组接受保乳手术和放疗的导管原位癌（DCIS）患者的结局，并评估追加放疗对局部复发发展的独立影响。
在 1994 年至 2003 年间，在安大略省诊断为 DCIS 并接受保乳手术和放疗的所有女性均被确定为研究对象。通过行政数据库确定治疗方法和结局，并通过病历回顾进行验证。使用生存分析确定追加放疗对局部复发发展的影响。
我们确定了 1895 例接受保乳手术和放疗的 DCIS 患者；561 例患者接受了追加放疗。接受追加放疗的女性 10 年局部复发累积率为 13%，未接受的为 12%（P=.3）。接受和未接受追加放疗的女性 10 年局部无复发生存率（LRFS）分别为 88%和 87%（P=.27），浸润性 LRFS 分别为 94%和 93%（P=.58），DCIS-LRFS 分别为 95%和 93%（P=.31）。多变量分析显示，追加放疗与局部复发风险降低无关（风险比=0.82，95%置信区间 0.59-1.15）（P=.25）。
在接受保乳手术和放疗的 DCIS 患者人群中，额外的（追加）放疗与较低的局部或浸润性复发风险无关。
