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老年乳腺癌患者保乳手术后省略放疗的利弊

Pros and cons of radiotherapy omission in elderly breast cancer patients following breast conservative surgery.

作者信息

Carvalho Ícaro T, Rezende Ana C P, Bernardo Renata J C

机构信息

Department of Radiation Oncology, Israeli Hospital Albert Einstein, São Paulo, Brazil.

Clinical Fellow, Israeli Hospital Albert Einstein, São Paulo, Brazil.

出版信息

Transl Cancer Res. 2020 Jan;9(Suppl 1):S236-S241. doi: 10.21037/tcr.2019.10.39.

DOI:10.21037/tcr.2019.10.39
PMID:35117967
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8797552/
Abstract

Breast cancer is a highly prevalent disease worldwide, with adjuvant radiation therapy (RT) being considered standard of care after breast-conserving surgery (BCS). Older patient population can present multiple running comorbidities and less aggressive tumor behavior, and the absolute impact of adjuvant RT on local control can be low. This article aims to review the available literature about the impact of adjuvant RT, discussing characteristics to identify lower risk cases, and advantages and disadvantages of the omission of adjuvant radiotherapy in this group.

摘要

乳腺癌是一种在全球范围内高度流行的疾病，保乳手术（BCS）后辅助放疗（RT）被视为标准治疗方案。老年患者群体可能存在多种并存疾病，且肿瘤行为侵袭性较低，辅助放疗对局部控制的绝对影响可能较小。本文旨在综述关于辅助放疗影响的现有文献，讨论识别低风险病例的特征，以及该群体省略辅助放疗的利弊。

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Pros and cons of radiotherapy omission in elderly breast cancer patients following breast conservative surgery.老年乳腺癌患者保乳手术后省略放疗的利弊
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[Local relapse in young (< or = 40 years) women with breast cancer after mastectomy or breast conserving surgery: 15-year results].[40岁及以下年轻女性乳腺癌乳房切除或保乳手术后的局部复发：15年结果]
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引用本文的文献

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The effect of adjuvant radiotherapy after breast-conserving surgery in elderly women with T1-2N0 estrogen receptor-negative breast cancer.保乳手术后辅助放疗对 T1-2N0 雌激素受体阴性老年女性乳腺癌的影响。
PLoS One. 2023 Aug 3;18(8):e0288078. doi: 10.1371/journal.pone.0288078. eCollection 2023.
2
Special Techniques of Adjuvant Breast Carcinoma Radiotherapy.辅助性乳腺癌放疗的特殊技术
Cancers (Basel). 2022 Dec 31;15(1):298. doi: 10.3390/cancers15010298.
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The addition of radiotherapy to breast-conserving surgery improves survival for elderly patients with early breast cancer.保乳手术联合放疗可提高老年早期乳腺癌患者的生存率。
Front Oncol. 2022 Nov 23;12:917054. doi: 10.3389/fonc.2022.917054. eCollection 2022.
4
Decreases in Radiation Oncology Medicare Reimbursement Over Time: Analysis by Billing Code.放疗医保报销随时间减少：按计费代码分析。
Int J Radiat Oncol Biol Phys. 2022 Sep 1;114(1):47-56. doi: 10.1016/j.ijrobp.2022.05.018. Epub 2022 May 22.

本文引用的文献

1
Breast Cancer Biology: Clinical Implications for Breast Radiation Therapy.乳腺癌生物学：对乳腺放射治疗的临床意义
Int J Radiat Oncol Biol Phys. 2018 Jan 1;100(1):23-37. doi: 10.1016/j.ijrobp.2017.08.025.
2
Omitting radiation therapy after lumpectomy for pure DCIS does not reduce the risk of salvage mastectomy.保乳术后省略放疗治疗单纯 DCIS 并不能降低挽救性乳房切除术的风险。
Breast. 2018 Feb;37:181-186. doi: 10.1016/j.breast.2017.07.002. Epub 2017 Aug 3.
3
Breaking Up Is Hard to Do: Omission of Radiation Therapy for Select Women Aged >70 Years With Breast Cancer.分手很难：对部分70岁以上乳腺癌女性省略放射治疗
Int J Radiat Oncol Biol Phys. 2017 Jul 15;98(4):918-921. doi: 10.1016/j.ijrobp.2017.03.006.
4
Tamoxifen with radiotherapy compared with Tamoxifen alone in elderly women with early-stage breast cancer treated with breast conserving surgery: A systematic review and meta-analysis.他莫昔芬联合放疗与单纯他莫昔芬治疗老年早期乳腺癌保乳术后患者的疗效比较：一项系统评价和荟萃分析。
Radiother Oncol. 2017 Apr;123(1):1-9. doi: 10.1016/j.radonc.2017.02.019.
5
21-Gene Recurrence Score and Locoregional Recurrence in Node-Positive/ER-Positive Breast Cancer Treated With Chemo-Endocrine Therapy.21基因复发评分与接受化疗-内分泌治疗的淋巴结阳性/雌激素受体阳性乳腺癌的局部区域复发
J Natl Cancer Inst. 2017 Jan 25;109(4). doi: 10.1093/jnci/djw259. Print 2017 Jan.
6
Personalized Radiation Oncology for Breast Cancer: The New Frontier.乳腺癌的个性化放射肿瘤学：新前沿
J Clin Oncol. 2015 Jun 20;33(18):1998-2000. doi: 10.1200/JCO.2015.61.2069. Epub 2015 May 11.
7
The genomic expression test EndoPredict is a prognostic tool for identifying risk of local recurrence in postmenopausal endocrine receptor-positive, her2neu-negative breast cancer patients randomised within the prospective ABCSG 8 trial.基因组表达检测EndoPredict是一种预后工具，用于识别在前瞻性ABCSG 8试验中随机分组的绝经后内分泌受体阳性、her2neu阴性乳腺癌患者的局部复发风险。
Br J Cancer. 2015 Apr 14;112(8):1405-10. doi: 10.1038/bjc.2015.98. Epub 2015 Mar 24.
8
Can older women with early breast cancer avoid radiation?早期乳腺癌老年女性可以避免放疗吗？
Lancet Oncol. 2015 Mar;16(3):235-7. doi: 10.1016/S1470-2045(15)70014-8. Epub 2015 Jan 28.
9
Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial.65 岁或以上早期乳腺癌女性中保乳手术联合或不联合放疗（PRIME II）：一项随机对照试验。
Lancet Oncol. 2015 Mar;16(3):266-73. doi: 10.1016/S1470-2045(14)71221-5. Epub 2015 Jan 28.
10
Patterns of care for omission of radiation therapy for elderly women with early-stage breast cancer receiving hormonal therapy.接受激素治疗的老年早期乳腺癌女性省略放射治疗的护理模式。
Pract Radiat Oncol. 2015 Jul-Aug;5(4):e267-73. doi: 10.1016/j.prro.2014.12.003. Epub 2015 Jan 22.