保乳术后放疗可提高T1-2期且腋窝淋巴结1-3个转移的局部区域复发高危乳腺癌患者的无病生存率。

Postmastectomy radiotherapy improves disease-free survival of high risk of locoregional recurrence breast cancer patients with T1-2 and 1 to 3 positive nodes.

作者信息

He Zhen-Yu, Wu San-Gang, Zhou Juan, Li Fang-Yan, Lin Qin, Lin Huan-Xin, Sun Jia-Yuan

机构信息

Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China.

Xiamen Cancer Center, Department of Radiation Oncology, the First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China.

出版信息

PLoS One. 2015 Mar 17;10(3):e0119105. doi: 10.1371/journal.pone.0119105. eCollection 2015.

DOI:10.1371/journal.pone.0119105

PMID:25781605

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4364521/

Abstract

OBJECTIVES

The indications for post-mastectomy radiotherapy (PMRT) with T1-2 breast cancer and 1-3 positive axillary lymph nodes is still controversial. The purpose of this study was to investigate the role of PMRT in T1-2 breast cancer with 1-3 positive axillary lymph node.

METHODS

We retrospectively reviewed the file records of 79 patients receiving PMRT and not receiving PMRT (618 patients).

RESULTS

The median follow-up was 65 months. Multivariate analysis showed that PMRT was an independent prognostic factor of locoregional recurrence-free survival (LRFS) (P = 0.010). Subgroup analysis of patients who did not undergo PMRT showed that pT stage, number of positive axillary lymph nodes, and molecular subtype were independent prognostic factors of LRFS. PMRT improved LRFS in the entire group (P = 0.005), but did not affect distant metastasis-free survival (DMFS) (P = 0.494), disease-free survival (DFS) (P = 0.215), and overall survival (OS) (P = 0.645). For patients without PMRT, the 5-year LRFS of low-risk patients (0-1 risk factor for locoregional recurrence) of 94.5% was significantly higher than that of high-risk patients (2-3 risk factors for locoregional recurrence) (80.9%, P < 0.001). PMRT improved LRFS (P = 0.001) and DFS (P = 0.027) in high-risk patients, but did not improve LRFS, DMFS, DFS, and OS in low-risk patients.

CONCLUSIONS

PMRT is beneficial in patients with high risk of locoregional recurrence breast cancer patients with T1-2 and 1 to 3 positive nodes.

摘要

目的

T1-2期乳腺癌且腋窝淋巴结1-3枚阳性患者行乳房切除术后放疗（PMRT）的指征仍存在争议。本研究旨在探讨PMRT在T1-2期乳腺癌且腋窝淋巴结1-3枚阳性患者中的作用。

方法

我们回顾性分析了79例行PMRT和未行PMRT患者（618例）的病历记录。

结果

中位随访时间为65个月。多因素分析显示，PMRT是局部区域无复发生存期（LRFS）的独立预后因素（P = 0.010）。对未行PMRT患者的亚组分析显示，pT分期、腋窝阳性淋巴结数目和分子亚型是LRFS的独立预后因素。PMRT改善了全组患者的LRFS（P = 0.005），但不影响无远处转移生存期（DMFS）（P = 0.494）、无病生存期（DFS）（P = 0.215）和总生存期（OS）（P = 0.645）。对于未行PMRT的患者，低风险患者（局部区域复发风险因素为0-1个）的5年LRFS为94.5%，显著高于高风险患者（局部区域复发风险因素为2-3个）（80.9%，P < 0.001）。PMRT改善了高风险患者的LRFS（P = 0.001）和DFS（P = 0.027），但未改善低风险患者的LRFS、DMFS、DFS和OS。