接受术中放疗患者的21基因复发检测：“有利”特征是否是低复发的替代指标？
21-gene recurrence assay in patients receiving intraoperative radiotherapy: are "favorable" characteristics a surrogate for low recurrence?
作者信息
Oppong Bridget A, Sen Gupta Surupa, Gary Monique, Wehner Patricia, Mete Mihriye, Zhao Danjing, Seevaratnam Sulakshana, Rudra Sonali, Willey Shawna C
机构信息
Department of Surgery, MedStar Georgetown University Hospital, Washington, DC, USA.
Washington Cancer Institute, MedStar Washington Hospital Center, Washington, DC, USA.
出版信息
Gland Surg. 2017 Dec;6(6):675-681. doi: 10.21037/gs.2017.07.05.
BACKGROUND
Intraoperative radiotherapy (IORT) has gained momentum for early stage and favorable breast cancers (BC). The 21-gene recurrence assay guides treatment of hormone positive and node-negative BC.
METHODS
Analysis of 82 invasive BC treated with breast conservation surgery (BCS) and IORT 2013-2015. Data collection included patient demographics, tumor characteristics, nodal status, recurrence test (RS) and adjuvant therapy.
RESULTS
The mean age was 68 years. Tumors were stage Ia (86.6%), 3.6% Ib and 9.8% IIa. Of 50 patients (61.0%) with RS testing, 72% (n=36) were low risk (RS 0-17), with 28% (n=14) at intermediate risk (RS 18-30). The 39% (n=32) of patients without RS testing, were more likely to have smaller tumors (1.3 0.9 cm) and age >70 (P<0.05).
CONCLUSIONS
Most patients selected for IORT based on clinical features were indeed low risk based on RS. Given the limited long-term clinical outcome and safety data of this technique, additional investigation is needed.
背景
术中放疗（IORT）在早期及预后良好的乳腺癌（BC）治疗中得到了更多应用。21基因复发检测可指导激素受体阳性且腋窝淋巴结阴性的乳腺癌治疗。
方法
分析2013 - 2015年接受保乳手术（BCS）及IORT治疗的82例浸润性乳腺癌患者。数据收集包括患者人口统计学信息、肿瘤特征、淋巴结状态、复发检测（RS）及辅助治疗情况。
结果
患者平均年龄68岁。肿瘤分期为Ia期（86.6%）、Ib期（3.6%）及IIa期（9.8%）。在50例（61.0%）进行RS检测的患者中，72%（n = 36）为低风险（RS 0 - 17），28%（n = 14）为中风险（RS 18 - 30）。39%（n = 32）未进行RS检测的患者，肿瘤更可能较小（1.3 ± 0.9 cm）且年龄>70岁（P<0.05）。
结论
基于临床特征选择接受IORT治疗的大多数患者，根据RS检测结果确实为低风险。鉴于该技术的长期临床结局和安全性数据有限，需要进一步研究。
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