Kim Haeyoung, Park Won, Yu Jeong Il, Choi Doo Ho, Huh Seung Jae, Kim Yeon-Joo, Lee Eun Sook, Lee Keun Seok, Kang Han-Sung, Park In Hae, Shin Kyung Hwan, Kim Kyubo, Park Kyung Ran, Kim Yong Bae, Ahn Sung Ja, Lee Jong Hoon, Kim Jin Hee, Chun Mison, Lee Hyung-Sik, Kim Jung Soo, Lee Jong-Young
Department of Radiation Oncology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi, South Korea.
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Oncotarget. 2017 Jan 3;8(1):1796-1804. doi: 10.18632/oncotarget.12882.
This study was performed to determine optimal radiation dose in pN1 breast cancer patients who received breast conserving surgery (BCS) and anthracycline plus taxane (AT)-based chemotherapy.
Retrospective chart reviews were performed in 1,147 patients who were treated between January 2006 and December 2010. The impact of radiation dose on treatment outcomes was evaluated.
Median follow-up time was 66 months. The 5-year rate of disease-free survival (DFS) was 93.2%. Larger tumor size (> 20 mm), positive lymphovascular invasion, high histologic grade, and high ratio of positive nodes (> 0.1) were significantly associated with inferior DFS. By using the 4 factors related to DFS, patients were categorized into high-risk (with ≥ 3 factors) and low-risk (with < 3 factors) groups. In the high-risk group, higher radiation dose (> 60.3 GyEQD2) was significantly associated with better DFS than the lower dose (≤ 60.3 GyEQD2). However, the radiation dose did not impact DFS in the low-risk group.
Dosing of radiation affects the outcome of post-BCS radiotherapy in pN1 breast cancer. Doses of over 60.3 GyEQD2 were associated with better outcome in the high-risk patients.
本研究旨在确定接受保乳手术（BCS）及基于蒽环类药物联合紫杉烷（AT）化疗的pN1期乳腺癌患者的最佳放疗剂量。
对2006年1月至2010年12月期间接受治疗的1147例患者进行回顾性病历审查。评估放疗剂量对治疗结果的影响。
中位随访时间为66个月。5年无病生存率（DFS）为93.2%。肿瘤较大（>20mm）、淋巴管浸润阳性、组织学分级高以及阳性淋巴结比例高（>0.1）与较差的DFS显著相关。利用与DFS相关的4个因素，将患者分为高危（≥3个因素）和低危（<3个因素）组。在高危组中，较高放疗剂量（>60.3 GyEQD2）与较低剂量（≤60.3 GyEQD2）相比，DFS显著更好。然而，放疗剂量对低危组的DFS没有影响。
放疗剂量影响pN1期乳腺癌保乳术后放疗的结果。超过60.3 GyEQD2的剂量与高危患者更好的预后相关。
