T1/T2 N1期疾病患者乳房切除术后放疗的效用：一项回顾性队列研究。
Utility of post mastectomy radiotherapy among patients with T1/ T2 N1 disease: A retrospective cohort study.
作者信息
Vohra Lubna M, Soomro Rufina, Jabeen Dua, Ali Nasir, Khan Nargis
机构信息
Department of Breast Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Department of Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan.
出版信息
Ann Med Surg (Lond). 2021 Apr 16;65:102295. doi: 10.1016/j.amsu.2021.102295. eCollection 2021 May.
BACKGROUND
Pakistan has the highest incidence of breast cancer among Asian Countries but there is insufficient representation of local data addressing breast cancer treatment and outcome. We sought to determine the role of post-mastectomy radiotherapy (PMRT) in T1- T2 breast cancer with 1-3 positive axillary lymph nodes.
METHODS
Data was reviewed retrospectively of total 755 patients out of which 291 received PMRT and 464 did not from two large breast cancer centres.
RESULTS
With a median follow up of 78 months, 4 (4.5%) patients developed loco regional recurrence (LRR) in the PMRT group while a substantial number 74 (24.4%) recurred in the non PMRT group (p = 0.000). Loco regional free survival rate (LRFS) and overall survival rate (OS) was significantly better for PMRT patients than non-PMRT patients (P = <0.000). Multivariate analysis identified young age, lymphovascular invasion, extra capsular extension, triple negative and ER/PR negative were independent prognostic factors affecting loco regional free survival (LRFS).
CONCLUSION
Disease recurrence is a substantial issue in 1-3 node group despite early stage, PMRT has an instrumental effect in improving LRFS and OS.
背景
在亚洲国家中，巴基斯坦的乳腺癌发病率最高，但关于乳腺癌治疗及预后的本地数据却非常有限。我们试图确定保乳术后放疗（PMRT）在腋窝淋巴结1 - 3个阳性的T1 - T2期乳腺癌中的作用。
方法
回顾性分析了来自两个大型乳腺癌中心的755例患者的数据，其中291例接受了保乳术后放疗，464例未接受。
结果
中位随访78个月，保乳术后放疗组有4例（4.5%）患者出现局部区域复发（LRR），而未接受保乳术后放疗组有74例（24.4%）复发（p = 0.000）。保乳术后放疗患者的局部区域无复发生存率（LRFS）和总生存率（OS）显著优于未接受保乳术后放疗的患者（P = <0.000）。多因素分析确定年龄小、淋巴管浸润、包膜外侵犯、三阴性以及雌激素受体/孕激素受体阴性是影响局部区域无复发生存（LRFS）的独立预后因素。
结论
尽管处于早期阶段，但在腋窝淋巴结1 - 3个阳性的患者中，疾病复发仍是一个重大问题，保乳术后放疗对改善局部区域无复发生存率（LRFS）和总生存率（OS）有重要作用。
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