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一项基于人群的关于不同肿瘤分期及放疗应用的乳腺小细胞癌预后分析。

A population-based analysis of outcomes for small cell carcinoma of the breast by tumor stage and the use of radiation therapy.

作者信息

Hare Felicia, Giri Smith, Patel Jashmin K, Hahn Andrew, Martin Michael G

机构信息

Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, USA.

Department of Hematology/Oncology, The West Cancer Center/University of Tennessee Health Science Center, 1588 Union Ave., Memphis, TN 38104 USA.

出版信息

Springerplus. 2015 Mar 21;4:138. doi: 10.1186/s40064-015-0913-y. eCollection 2015.

Abstract

PURPOSE

Primary small cell carcinomas of the breast (SCCB) are rare tumors with limited data on outcomes and treatment strategies. Using a population based approach, we aimed to study outcomes of SCCB and determine whether the use of radiation therapy is associated with better survival among patients with SCCB.

METHODS

Using the Surveillance, Epidemiology and End Results (SEER) registry, we identified patients with SCCB between1973 and 2010. We examined the stage specific survival of these patients and compared it to the stage specific survival of small cell lung cancer (SCLC) from the SEER database over the same accrual period. We further analyzed the impact of radiation therapy on overall survival for SCCB patients using a univariate and multivariate approach.

RESULTS

A total of 199 patients with primary SCCB with staging were identified during the study period. Eighty-four patients (42%) had localized disease, 77 (39%) had regional disease and 38 (19%) had distant disease. For comparison, 81,933 patients with SCLC were identified. Outcomes were superior for patients with SCCB with localized (150 vs. 16 months, p < 0.01) and regional disease (56 vs. 13 months, p < 0.01), but not distant disease (7 vs. 7 months, p = 0.43). Use of radiation therapy was not associated with a significant difference in OS for patients with either localized (202 vs. 147 months, p = 0.48) or regional (52 vs. 75 months, p = 0.650) disease.

CONCLUSIONS

SCCB has a more favorable prognosis by stage for localized and regional disease than SCLC. Adjuvant radiation is not associated with an improvement in survival for patients with localized or regional SCCB in this dataset.

摘要

目的

原发性乳腺小细胞癌(SCCB)是罕见肿瘤,关于其预后和治疗策略的数据有限。我们采用基于人群的方法,旨在研究SCCB的预后,并确定放疗的使用是否与SCCB患者更好的生存率相关。

方法

利用监测、流行病学和最终结果(SEER)登记系统,我们确定了1973年至2010年间患有SCCB的患者。我们检查了这些患者的分期特异性生存率,并将其与同一累积期内SEER数据库中小细胞肺癌(SCLC)的分期特异性生存率进行比较。我们还使用单变量和多变量方法进一步分析了放疗对SCCB患者总生存期的影响。

结果

在研究期间共确定了199例有分期的原发性SCCB患者。84例(42%)为局限性疾病,77例(39%)为区域性疾病,38例(19%)为远处疾病。作为对照,确定了81933例SCLC患者。局限性(150个月对16个月,p<0.01)和区域性疾病(56个月对13个月,p<0.01)的SCCB患者预后较好,但远处疾病患者(7个月对7个月,p=0.43)并非如此。对于局限性(202个月对147个月,p=0.48)或区域性疾病(52个月对75个月,p=0.650)的患者,放疗的使用与总生存期的显著差异无关。

结论

SCCB局限性和区域性疾病分期的预后比SCLC更有利。在该数据集中,辅助放疗与局限性或区域性SCCB患者的生存率改善无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f123/4382500/5f1f7f1d963e/40064_2015_913_Fig1_HTML.jpg

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