Yadav Budhi Singh, Das Deepak, Bansal Anshuma, Dahiya Divya
PGIMER, Radiotherapy and Oncology, Chandigarh, India.
GMC, Patiala, Radiation Oncology, Patiala, India.
Rep Pract Oncol Radiother. 2022 May 19;27(2):281-290. doi: 10.5603/RPOR.a2022.0028. eCollection 2022.
Young women with breast cancer (BC) are not represented in the trials on hypofractionation. In this study we compared outcomes in young patients with BC to their older counterparts treated with hypofractionated radiotherapy (RT) in a regional cancer centre in India.
Between January 1990 to December 2010, women with BC, treated with hypofractionated RT dose of 35-40 Gy/15#/3 weeks were divided into two groups, ≤ 35 years and > 35 years. Outcomes compared were locoregional recurrence rate (LRR), locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), overall survival (OS) and toxicities. LRRFS, DFS and OS were estimated using the Kaplan-Meier method.
Of total 2244 patients, 359 were ≤ 35 years of age and 1885 were > 35 years. Patient and disease characteristics were comparable between the two groups, except that comorbidities were significantly higher in the > 35 years age group, more patients aged ≤ 35 years had nodal N3 disease, received chemotherapy and RT to internal mammary nodes and more patients in the > 35 years group received hormonal therapy. Median follow up was 10 years (range 1-30 years). LRR and distant metastases were comparable between the two groups. However, synchronous LRR and distant metastases were significantly higher in the ≤ 35 years group 18 (5.1%) as compared to the > 35 years group 39 (2.1%) with p = 0.018. Estimated 10-year LRRFS, DFS and OS were 92% . 94% (p = 0.95), 68% . 73%(p = 0.058) and 78% . 76% (p = 0.10) in ≤ 35 years and > 35 years, respectively. OS for stage 1 was comparable between the two groups. However, for stage 2 and 3 it was 77% . 82% (p = 0.048) and 53% . 62% (p = 0.045) in the ≤ 35 years and > 35 years group, respectively. Acute and late toxicity were similar in the two groups.
Young BC patients had higher LRR and distant metastases. LRRFS, DFS and toxicities were comparable between the two groups. However, OS was poorer in young BC patients with stage 2 and 3 disease.
乳腺癌（BC）年轻女性未纳入短程放疗试验。在本研究中，我们比较了印度一家地区癌症中心接受短程放疗（RT）的年轻BC患者与其年长对应患者的治疗结果。
1990年1月至2010年12月期间，接受35 - 40 Gy/15次/3周短程放疗剂量的BC女性患者被分为两组，年龄≤35岁和>35岁。比较的结果包括局部区域复发率（LRR）、无局部区域复发生存率（LRRFS）、无病生存率（DFS）、总生存率（OS）和毒性反应。LRRFS、DFS和OS采用Kaplan-Meier法估算。
在总共2244例患者中，359例年龄≤35岁，1885例年龄>35岁。两组患者及疾病特征具有可比性，但>35岁年龄组的合并症显著更多，年龄≤35岁的患者中更多有N3期淋巴结疾病、接受化疗及内乳淋巴结放疗，>35岁组更多患者接受激素治疗。中位随访时间为10年（范围1 - 30年）。两组间LRR和远处转移情况具有可比性。然而，年龄≤35岁组同步LRR和远处转移显著高于>35岁组，分别为18例（5.1%）和39例（2.1%），p = 0.018。年龄≤35岁和>35岁组的估计10年LRRFS、DFS和OS分别为92%、94%（p = 0.95），68%、73%（p = 0.058）和78%、76%（p = 0.10）。1期患者的OS在两组间具有可比性。然而，2期和3期患者中，年龄≤35岁组分别为77%、82%（p = 0.048）和53%、62%（p = 0.045），>35岁组分别为77%和82%（p = 0.048）以及53%和62%（p = 0.045）。两组的急性和晚期毒性反应相似。
年轻BC患者的LRR和远处转移更高。两组间LRRFS、DFS和毒性反应具有可比性。然而，2期和3期疾病的年轻BC患者OS较差。
