Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California, USA.
Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
Sci Rep. 2017 Oct 3;7(1):12587. doi: 10.1038/s41598-017-12949-5.
Adjuvant radiotherapy (RT) in breast cancer (BC) is often used to eradicate remaining tumor cells following surgery with the goal of maximizing local control and increasing overall survival. The current study investigated the impact of age and BC molecular subtype on overall survival after RT using a meta-analysis of the METABRIC and TCGA BC patient cohorts. We found that RT significantly prolonged survival across the whole BC patient population. The survival benefit of RT was predominantly observed in stage II BC patients treated with breast conserving surgery. Patients were then stratified by age and molecular subtype to investigate survival rate associated with RT. An increase in survival for the luminal-A and basal BC molecular subtypes was observed after RT. Stratifying patients based on age revealed that increased survival was restricted to younger patients (≤60 years of age at diagnosis). There was a significant survival benefit of radiotherapy for younger patients with tumors of the luminal A and basal molecular subtypes. Patients with other breast tumor subtypes or older breast cancer patients did not seem to benefit effects of RT. Therefore, alternate local treatment strategies should be considered for older, luminal B, and HER2 driven BC patients.
辅助放疗（RT）在乳腺癌（BC）中经常用于在手术后消灭残留的肿瘤细胞，目的是最大限度地提高局部控制率并提高总生存率。本研究通过对 METABRIC 和 TCGA BC 患者队列的荟萃分析，调查了年龄和 BC 分子亚型对 RT 后总生存率的影响。我们发现 RT 显著延长了整个 BC 患者群体的生存期。RT 的生存获益主要在接受保乳手术的 II 期 BC 患者中观察到。然后根据年龄和分子亚型对患者进行分层，以研究与 RT 相关的生存率。在接受 RT 后， luminal-A 和基底 BC 分子亚型的生存率增加。根据年龄分层显示，生存率的提高仅限于年轻患者（诊断时≤60 岁）。对于 luminal A 和基底分子亚型的年轻肿瘤患者，放疗具有显著的生存获益。其他乳腺肿瘤亚型或老年乳腺癌患者似乎没有从 RT 中受益。因此，对于年龄较大、luminal B 和 HER2 驱动的 BC 患者，应考虑其他局部治疗策略。
