Department of Epidemiology, Medisch Spectrum Twente, Koningstraat 1, 7512 KZ, Enschede, The Netherlands.
Breast Clinic Oost-Nederland, ZGT, Hengelo, The Netherlands.
Strahlenther Onkol. 2022 Mar;198(3):268-281. doi: 10.1007/s00066-021-01877-z. Epub 2021 Nov 29.
To investigate the effect of the timing of radiation therapy after breast-conserving surgery in relation to distant metastasis-free survival and disease-specific survival.
The analysis was performed in relation to 4189 women all undergoing breast-conserving therapy (BCT). Three groups were defined with respect to lymph node status and the use of adjuvant systemic therapy (AST). Patients were categorized into time intervals: < 37 days, 37-53 days, 54-112 days and > 112 days.
For women without lymph node metastases and with favourable characteristics aged > 55 years, an improved treatment efficacy was noted when starting radiotherapy with a time interval of < 37 days. The same was observed for women with lymph nodes metastases receiving AST aged ≤ 50 years. Finally, for women aged > 50 years with negative lymph node status but with unfavourable characteristics and receiving AST, an improved treatment efficacy was noted when starting radiotherapy after a time interval of ≥ 37 days.
The results of our study further support the hypothesis that the timing of radiotherapy may have an impact on treatment efficacy and that further studies (preferably randomized trials) are indicated.
研究保乳手术后放疗时间与远处无转移生存和疾病特异性生存的关系。
对 4189 名接受保乳治疗（BCT）的女性进行了分析。根据淋巴结状态和辅助全身治疗（AST）的使用情况，将患者分为三组。将患者分为时间间隔：<37 天、37-53 天、54-112 天和>112 天。
对于无淋巴结转移且年龄>55 岁、特征良好的女性，如果放疗开始时间间隔<37 天，治疗效果更好。年龄≤50 岁、接受 AST 且有淋巴结转移的女性也观察到了同样的结果。最后，对于年龄>50 岁、淋巴结阴性但特征不良且接受 AST 的女性，如果放疗开始时间间隔≥37 天，治疗效果更好。
我们的研究结果进一步支持了放疗时间可能影响治疗效果的假设，需要进一步研究（最好是随机试验）。
