Gultekin Melis, Yazici Ozan, Eren Gulnihan, Yuce Deniz, Aksoy Sercan, Ozisik Yavuz, Guler Nilufer, Yazici Gozde, Hurmuz Pervin, Yildiz Ferah, Altundag Kadri, Gurkaynak Murat
Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey.
Medical Oncology Clinic, Education and Research Hospital, Ankara Numune Hospital, Ankara, Turkey.
Breast. 2014 Dec;23(6):775-83. doi: 10.1016/j.breast.2014.08.008. Epub 2014 Sep 5.
In this study, we tried to evaluate the efficacy of locoregional treatment (LRT) in patients with metastatic breast carcinoma (MBC).
The medical records of 227 patients with MBC at initial presentation between April 1999 and January 2013 were retrospectively evaluated. The median age at diagnosis was 50 years (range, 27-83 years). Thirty-nine patients (17%) had no LRT. Among patients who had LRT, 2 (1%) had locoregional radiotherapy (RT) alone, 54 (29%) had surgery alone [mastectomy, n = 50; breast conserving surgery (BCS), n = 4] and 132 (70%) had surgery (mastectomy, n = 119; BCS, n = 13) followed by locoregional RT.
The median follow-up time was 35 months (range, 4-149 months). Five-year OS and PFS rates were 44% and 20%, respectively. In both univariate and multivariate analysis LRT per se did not affect OS and PFS rates. However, the 5-year OS and PFS rates were significantly higher in patients treated with locoregional RT than the ones who were not. The corresponding rates were 56% vs. 24% for OS and 27% vs. 7% for PFS (p < 0.001). Median survival was 67 months and 37 months, respectively.
Our study showed that patients with MBC who received postoperative locoregional RT may have a survival advantage compared with patients who were only treated by surgery. A phase III trial testing the role of adjuvant locoregional RT may help to distinguish patients who will benefit from adjuvant RT.
在本研究中，我们试图评估局部区域治疗（LRT）对转移性乳腺癌（MBC）患者的疗效。
回顾性评估了1999年4月至2013年1月期间初诊的227例MBC患者的病历。诊断时的中位年龄为50岁（范围27 - 83岁）。39例患者（17%）未接受LRT。在接受LRT的患者中，2例（1%）仅接受局部区域放疗（RT），54例（29%）仅接受手术治疗[乳房切除术，n = 50；保乳手术（BCS），n = 4]，132例（70%）接受手术（乳房切除术，n = 119；BCS，n = 13）后进行局部区域RT。
中位随访时间为35个月（范围4 - 149个月）。5年总生存率（OS）和无进展生存率（PFS）分别为44%和20%。在单因素和多因素分析中，LRT本身并不影响OS和PFS率。然而，接受局部区域RT治疗的患者的5年OS和PFS率显著高于未接受该治疗的患者。OS的相应比率分别为56%对24%，PFS为27%对7%（p < 0.001）。中位生存期分别为67个月和37个月。
我们的研究表明，与仅接受手术治疗的患者相比，接受术后局部区域RT的MBC患者可能具有生存优势。一项测试辅助局部区域RT作用的III期试验可能有助于区分将从辅助RT中获益的患者。
