Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumore, Milan, Italy.
Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Milan, Italy.
Breast J. 2020 Feb;26(2):188-196. doi: 10.1111/tbj.13489. Epub 2019 Aug 25.
To assess the efficacy, and the acute and late toxicity of hypofractionated radiotherapy (Hypo-RT), and the impact of age and comorbidities on disease progression and death in elderly breast cancer (BC) patients. Women aged ≥65 years who received Hypo-RT (42.4 Gy in 16 fractions, plus a boost for high-risk patients) were considered for the present analysis. Competing risk analysis was used to estimate the 5-year cumulative incidence of BC progression and BC-related death, calculating the adjusted subhazard ratios (SHR) with 95% confidence intervals (95%CI) in relation to age, hypertension-augmented Charlson Comorbidity Index (hCCI), tumor characteristics, and chemotherapy. The sample included 794 patients with a median age of 74 years (range 65-91 years). At the baseline, 70% of these patients had at least one comorbidity. With a median follow-up of 48.3 months, the 5-year cumulative incidence of BC progression and BC-related death was 6.7% (95%CI 4.8%-9.2%) and 2.3% (95%CI 1.2%-3.9%), respectively. Old age (≥80 years) and a high burden of comorbidity (hCCI ≥ 2) were independently associated with BC progression. Hypo-RT is safe in elderly BC patients, but age and comorbidities influence BC progression. Further studies are warranted.
评估老年乳腺癌（BC）患者中短程分割放疗（Hypo-RT）的疗效、急性和晚期毒性，以及年龄和合并症对疾病进展和死亡的影响。考虑对接受 Hypo-RT（42.4Gy 分 16 次给予，高危患者加量）的年龄≥65 岁的女性进行本分析。使用竞争风险分析估计 BC 进展和 BC 相关死亡的 5 年累积发生率，计算与年龄、高血压增强 Charlson 合并症指数（hCCI）、肿瘤特征和化疗相关的调整后亚危险比（SHR）及其 95%置信区间（95%CI）。样本包括 794 例中位年龄为 74 岁（范围 65-91 岁）的患者。在基线时，这些患者中有 70%至少有 1 种合并症。中位随访 48.3 个月后，BC 进展和 BC 相关死亡的 5 年累积发生率分别为 6.7%（95%CI 4.8%-9.2%）和 2.3%（95%CI 1.2%-3.9%）。高龄（≥80 岁）和合并症负担重（hCCI≥2）与 BC 进展独立相关。Hypo-RT 对老年 BC 患者是安全的，但年龄和合并症会影响 BC 进展。需要进一步研究。
