Jardel Pauline, Vignot Stéphane, Cutuli Bruno, Creisson Anne, Vass Sylvie, Barranger Emmanuel, Thariat Juliette
Department of Radiation Oncology, Chicoutimi Hospital, Saguenay, QC, Canada.
Department of Medical Oncology, Louis Pasteur Hospital, Le Coudray, France.
Anticancer Res. 2018 Jan;38(1):23-31. doi: 10.21873/anticanres.12187.
Guidelines for radiotherapy in male breast cancer (MBC) are lacking. Some extrapolate the results from female breast cancer trials, while others advocate systematic adjuvant irradiation. We evaluated clinical practices and outcomes with respect to radiation therapy in MBC treated with locoregional irradiation in the adjuvant setting using a systematic literature review.
We included studies with data about adjuvant radiotherapy published between 1984 and 2017 and including at least 40 patients.
We found 29 retrospective series, 10,065 men were diagnosed with breast cancer; 3-100% (mean=54%) received adjuvant radiotherapy. Tumor size and nodal involvement were the strongest prognostic factors. Approximatively half of all cases had nodal metastases. Radiation therapy improved locoregional control in six series, overall survival in three and distant metastasis-free survival in one.
MBC is diagnosed at a highly advanced stage and may be linked with poorer outcomes. Adjuvant radiation therapy must, at least, be proposed to men with positive nodes. Despite the large number of cases gathered here, arguments for radiotherapy in other prognostic subgroups (especially in pN0) may exist but are not well supported.
男性乳腺癌（MBC）的放疗指南尚不完善。一些人从女性乳腺癌试验中推断结果，而另一些人则主张进行系统性辅助放疗。我们通过系统的文献综述，评估了在辅助治疗中接受局部区域放疗的MBC患者的临床实践和放疗结果。
我们纳入了1984年至2017年间发表的、包含辅助放疗数据且至少有40例患者的研究。
我们发现了29个回顾性系列研究，共有10065名男性被诊断为乳腺癌；3% - 100%（平均为54%）接受了辅助放疗。肿瘤大小和淋巴结受累是最强的预后因素。所有病例中约一半有淋巴结转移。放疗在6个系列研究中改善了局部区域控制，在3个系列中改善了总生存期，在1个系列中改善了无远处转移生存期。
MBC确诊时往往处于晚期，可能与较差的预后相关。至少，对于淋巴结阳性的男性患者应建议进行辅助放疗。尽管这里收集了大量病例，但对于其他预后亚组（尤其是pN0）进行放疗的依据可能存在，但支持不足。
