Méry Benoite, Assouline Avi, Rivoirard Romain, Bosacki Claire, Auberdiac Pierre, Falk Alexander T, Trone Jane-Chloé, Guy Jean-Baptiste, Jacquin Jean-Philippe, Merrouche Yacine, Chargari Cyrus, Magné Nicolas
Departement of Medical Oncology, Institut Lucien Neuwirth, St. Priest en Jarez Cedex, France.
Department of Radiotherapy, Clinical Center of Porte de Saint Cloud, Boulogne-Billancourt, France.
Breast. 2014 Jun;23(3):221-5. doi: 10.1016/j.breast.2014.03.006. Epub 2014 Apr 13.
There are only scarce data on the management of nonagenarians with breast cancer, and more particularly on the place of radiation therapy (RT). We report a retrospective study on patients aged 90 years old or older, with breast cancer, receiving RT. Records from RT departments from five institutions were reviewed to identify patients 90 years old of age and older undergoing RT over past decade for breast cancer. Tumors' characteristics were examined, as well treatment specificities and treatment intent. 44 patients receiving RT courses were identified, mean age 92 years. Treatment was given with curative and palliative intent in 72.7% and 27.3% respectively. Factors associated with a curative treatment were performance status (PS), place of life, previous surgery, and tumor stage. Median total prescribed dose was 40 Gy (23-66). Hypo fractionation was used in 77%. Most toxicities were mild to moderate. RT could not be completed in 1 patient (2.3%). No long-term toxicity was reported. Among 31 patients analyzable for effectiveness, 24 patients (77.4%) had their diseased controlled until last follow-up, including 17 patients (54.8%) experiencing complete response. At last follow-up, 4 patients (12.9%) were deceased, cancer being cause of death for two of them. The study shows that breast/chest RT is feasible in nonagenarians. Although the definitive benefit of RT could not be addressed here, hypofractionated therapy allowed a good local control with acceptable side effects.
关于老年乳腺癌患者的管理，尤其是放射治疗（RT）的应用，相关数据极为稀少。我们报告了一项针对90岁及以上接受RT的乳腺癌患者的回顾性研究。对五家机构放疗科的记录进行了审查，以确定过去十年中年龄在90岁及以上接受RT治疗的乳腺癌患者。研究了肿瘤特征、治疗特异性和治疗目的。共确定了44例接受RT疗程的患者，平均年龄92岁。分别有72.7%和27.3%的患者接受了根治性和姑息性治疗。与根治性治疗相关的因素包括体能状态（PS）、生活地点、既往手术和肿瘤分期。处方总剂量中位数为40 Gy（23 - 66）。77%的患者采用了短程分割放疗。大多数毒性反应为轻至中度。1例患者（2.3%）未能完成RT。未报告长期毒性反应。在可分析疗效的31例患者中，24例患者（77.4%）的疾病在最后一次随访时得到控制，其中17例患者（54.8%）实现了完全缓解。在最后一次随访时，4例患者（12.9%）死亡，其中2例死于癌症。该研究表明，90岁及以上患者进行乳房/胸部RT是可行的。尽管在此无法确定RT的确切益处，但短程分割放疗可实现良好的局部控制，且副作用可接受。
