乳房切除术后放疗对炎性乳腺癌具有显著的生存益处：一项基于监测、流行病学和最终结果（SEER）数据库的人群回顾性研究。

Radiotherapy after mastectomy has significant survival benefits for inflammatory breast cancer: a SEER population-based retrospective study.

作者信息

Li Zhi-Wen, Zhang Miao, Yang Yong-Jing, Zhou Zi-Jun, Liu Yan-Ling, Li Hang, Bao Bo, Diao Jian-Dong, Wang Dun-Wei

机构信息

Department of Anesthesiology, First Hospital of Jilin University, Changchun, Jilin, China.

Departments of Radiation Oncology, Jilin Cancer Hospital, Changchun, Jilin, China.

出版信息

PeerJ. 2020 Feb 3;8:e8512. doi: 10.7717/peerj.8512. eCollection 2020.

DOI:10.7717/peerj.8512

PMID:32117621

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7003697/

Abstract

OBJECTIVES

The survival benefit of postmastectomy radiotherapy (PMRT) has not been fully proven in inflammatory breast cancer (IBC). Thus, in the present research, we aimed at elucidating the effects of PMRT on the survival of IBC patients.

METHODS

Eligible patients were collected from the Surveillance, Epidemiology, and End Results (SEER) dataset between 2010 and 2013. The Kaplan-Meier method along with the log-rank test was utilized for the comparison of both the overall survival (OS) andthe cancer-specific survival (CSS) in patients undergoing PMRT or not. Additionally, multivariate survival analysis of CSS and OS were performed using the Cox proportional hazard model.

RESULTS

In total, 293 eligible cases were identified, with the median follow-up time of 27 months (range: 5-59 months). After propensity score matching (PSM), 188 patients (94 for each) were classified intothe No-PMRT and the PMRT group. Consequently, significantly higher OS rates were detected in the PMRT group compared with the No-PMRT group prior to PSM ( = 0.034), and significantly higher CSS ( = 0.013) and OS ( = 0.0063) rates were observed following PSM. Furthermore, multivariate analysis revealed thatPMRT [CSS (HR: 0.519, 95% CI [0.287-0.939], = 0.030); OS (HR: 0.480, 95% CI [0.269-0.859], = 0.013)], as well as Her2+/HR+ subtype, was independent favorable prognostic factors.Besides, black ethnicity, AJCC stage IV and triple-negative subtype were independent unfavorable prognostic factors. Further subgroup analysis revealed that most of the study population could benefit from PMRT, no matter OS or CSS.

CONCLUSIONS

Our findings support that PMRT could improve the survival of IBC patients.

摘要

目的

乳房切除术后放疗（PMRT）对炎性乳腺癌（IBC）患者的生存获益尚未得到充分证实。因此，在本研究中，我们旨在阐明PMRT对IBC患者生存的影响。

方法

从2010年至2013年的监测、流行病学和最终结果（SEER）数据集中收集符合条件的患者。采用Kaplan-Meier法和对数秩检验比较接受或未接受PMRT患者的总生存期（OS）和癌症特异性生存期（CSS）。此外，使用Cox比例风险模型对CSS和OS进行多因素生存分析。

结果

共确定293例符合条件的病例，中位随访时间为27个月（范围：5 - 59个月）。倾向评分匹配（PSM）后，188例患者（每组94例）被分为非PMRT组和PMRT组。结果显示，PSM前PMRT组的OS率显著高于非PMRT组（P = 0.034），PSM后CSS（P = 0.013）和OS（P = 0.0063）率显著更高。此外，多因素分析显示，PMRT [CSS（HR：0.519，95%CI [0.287 - 0.939]，P = 0.030）；OS（HR：0.480，95%CI [0.269 - 0.859]，P = 0.013）]以及Her2+/HR+亚型是独立的有利预后因素。此外，黑人种族、AJCC IV期和三阴性亚型是独立的不利预后因素。进一步的亚组分析显示，无论OS还是CSS，大多数研究人群都能从PMRT中获益。