Wu San-Gang, Sun Jia-Yuan, Liu Wen-Ming, Li Feng-Yan, Lin Huan-Xin, He Zhen-Yu
Xiamen Cancer Center, Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China.
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.
Oncotarget. 2016 Mar 1;7(9):10684-93. doi: 10.18632/oncotarget.7222.
The therapeutic value of postoperative radiotherapy (RT) for squamous cell cancer of the breast (SCCB) is unclear. This retrospective study used a population-based national registry to determine the impact of postoperative RT on survival of women with SCCB. The Surveillance Epidemiology and End Results (SEER) database was used to identify females with SCCB who underwent primary surgical resection from 1973 to 2012. Kaplan-Meier survival analysis and Cox regression proportional hazard methods were used to determine the impact of RT following resection associated with cause-specific survival (CSS) and overall survival (OS). A total of 523 patients met the eligibility criteria. The median follow-up time was 55 months, the 10-year CSS and OS rates were 65.6%, and 46.0%, respectively. A total of 167 patients (31.9%) received postoperative RT. Multivariate analysis indicated that advanced pT and pN stage, and no postoperative RT were independently associated with poor OS; advanced pT and pN stage were independently associated with poor CSS. Postoperative RT was significantly associated with improved 10-year OS (54.5% vs. 42.0%, P =.001), but had no effect on CSS (P =.217). Analysis of patients with different stages of SCCB indicated that RT was associated with improved CSS (P =.047) and OS (P <.001) in those with stage II cancer and improved OS in patients with stage pN0 cancer (P <.001). Postoperative RT improved the survival of SCCB patients, especially in those with stage II and stage pN0 cancer.
术后放疗（RT）对乳腺鳞状细胞癌（SCCB）的治疗价值尚不清楚。这项回顾性研究使用了基于人群的国家登记系统来确定术后放疗对SCCB女性患者生存的影响。利用监测、流行病学和最终结果（SEER）数据库，识别出1973年至2012年间接受原发性手术切除的SCCB女性患者。采用Kaplan-Meier生存分析和Cox回归比例风险方法来确定切除术后放疗与特定病因生存率（CSS）和总生存率（OS）的关系。共有523例患者符合纳入标准。中位随访时间为55个月，10年CSS率和OS率分别为65.6%和46.0%。共有167例患者（31.9%）接受了术后放疗。多因素分析表明，pT和pN分期较晚以及未接受术后放疗与较差的OS独立相关；pT和pN分期较晚与较差的CSS独立相关。术后放疗与10年OS改善显著相关（54.5%对42.0%，P = 0.001），但对CSS无影响（P = 0.217）。对不同分期SCCB患者的分析表明，放疗与II期癌症患者的CSS改善（P = 0.047）和OS改善（P < 0.001）以及pN0期癌症患者的OS改善（P < 0.001）相关。术后放疗改善了SCCB患者的生存率，尤其是II期和pN0期癌症患者。
