Forster Tobias, Köhler Clara, El Shafie Rami, Weykamp Fabian, König Laila, Arians Nathalie, Adeberg Sebastian, Michel Laura, Smetanay Katharina, Golatta Michael, Sohn Christof, Heil Jörg, Schneeweiss Andreas, Debus Jürgen, Hörner-Rieber Juliane
Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
Cancers (Basel). 2020 Dec 4;12(12):3645. doi: 10.3390/cancers12123645.
Due to its rarity, there are no randomized trials investigating the outcome of adjuvant radiotherapy in MBC. This study reports on patient and tumor characteristics of 41 consecutive MBC patients treated between 1990 and 2018 and on clinical outcomes after surgical resection of tumors and adjuvant radiotherapy of the chest wall or breast. Local control (LC), locoregional control (LRC), overall survival (OS), disease-free survival (DFS), and toxicity were evaluated. After a median follow-up of 80 months (95% CI: 14.6-213.8 months) there was only one recurrence, in a patient's locoregional lymph nodes 17 months after start of radiotherapy, resulting in an LC rate of 100% at 5 years and a 5-year LRC rate of 97.4% (standard deviation (SD): 0.025). Five-year DFS and OS rates were 64.6% (SD: 0.085) and 57.2% (SD: 0.082), respectively. Adjuvant radiotherapy was tolerated well without high-grade (CTCAE grade > II) adverse events. After tumor resection and adjuvant radiotherapy, LC and LRC rates in MBC patients are excellent and comparable to results found for female breast cancer (FBC) patients. However, as patients are often diagnosed with locally advanced, higher-risk tumors, distant recurrences remain the major failure pattern.
由于其罕见性,尚无关于转移性乳腺癌(MBC)辅助放疗结局的随机试验。本研究报告了1990年至2018年间连续治疗的41例MBC患者的患者和肿瘤特征,以及肿瘤手术切除和胸壁或乳房辅助放疗后的临床结局。评估了局部控制(LC)、区域淋巴结控制(LRC)、总生存期(OS)、无病生存期(DFS)和毒性。中位随访80个月(95%CI:14.6 - 213.8个月)后,仅1例患者在放疗开始后17个月出现区域淋巴结复发,5年LC率为100%,5年LRC率为97.4%(标准差(SD):0.025)。5年DFS率和OS率分别为64.6%(SD:0.085)和57.2%(SD:0.082)。辅助放疗耐受性良好,无高级别(CTCAE分级>II)不良事件。在肿瘤切除和辅助放疗后,MBC患者的LC和LRC率极佳,与女性乳腺癌(FBC)患者的结果相当。然而,由于患者常被诊断为局部晚期、高风险肿瘤,远处复发仍是主要的失败模式。