Kim Jin Hee, Choi Doo Ho, Park Won, Ahn Seung Do, Kim Su Ssan, Ha Sung Whan, Kim Kyubo, Kim Yong Bae, Yea Ji Woon, Kang Min Kyu, Shin Kyung Hwan, Kim Dong Won, Lee Ji Hae, Suh Chang-Ok
Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, 56 Dalseong-Ro, Jung-Gu, Daegu, Korea,
Breast Cancer Res Treat. 2014 Jul;146(2):341-5. doi: 10.1007/s10549-014-3025-4. Epub 2014 Jun 18.
To estimate the effect of boost radiotherapy on local recurrence-free survival (LRFS) in patients with ductal carcinoma in situ (DCIS) breast cancer. We included patients from nine institutions who met the following criteria: having Tis, age 18 years or older, having breast conserving surgery (BCS) and radiotherapy within 12 weeks after surgery. From 1995 through 2006, 728 patients were analyzed retrospectively by the Korean Radiation Oncology Group. All patients received whole-breast radiation therapy (WBRT) after BCS. 232 patients (31.9 %) also received boost radiation therapy (RT) (median 10 Gy). After median follow-up of 82 months, 5-year LRFS was 98.4 % and 10-year LRFS was 95.8 % for all patients. There was no statistically significant difference of LRFS between the boost and no-boost groups. Nineteen (2.6 %) patients had ipsilateral breast recurrences, including 12 of invasive recurrence and 7 DCIS. The presence of the HER2 receptor was associated with more invasive recurrences. Nine (1.2 %) patients developed contralateral breast cancer, including six invasive breast cancer and three DCIS. In the multivariate analysis, only the margin status was a significant prognostic factor for LRFS. Boost RT was not associated with further improvement of local control in DCIS after BCS and WBRT. HER2 receptor-positive patients may need further treatment with the anti-HER2 agents.
评估局部加强放疗对导管原位癌（DCIS）乳腺癌患者无局部复发生存率（LRFS）的影响。我们纳入了来自九个机构的符合以下标准的患者：患有Tis，年龄18岁及以上，接受保乳手术（BCS）且在术后12周内接受放疗。从1995年至2006年，韩国放射肿瘤学组对728例患者进行了回顾性分析。所有患者在BCS后均接受全乳放疗（WBRT）。232例患者（31.9%）还接受了加强放疗（RT）（中位剂量10 Gy）。中位随访82个月后，所有患者的5年LRFS为98.4%，10年LRFS为95.8%。加强放疗组和未加强放疗组之间的LRFS无统计学显著差异。19例（2.6%）患者出现同侧乳房复发，包括12例浸润性复发和7例DCIS。HER2受体的存在与更多浸润性复发相关。9例（1.2%）患者发生对侧乳腺癌，包括6例浸润性乳腺癌和3例DCIS。在多变量分析中，只有切缘状态是LRFS的显著预后因素。在BCS和WBRT后，加强RT与DCIS局部控制的进一步改善无关。HER2受体阳性患者可能需要用抗HER2药物进行进一步治疗。
