Department of Radiation Oncology, New York Proton Center, New York, NY, USA.
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
J Natl Cancer Inst. 2023 Sep 7;115(9):1029-1035. doi: 10.1093/jnci/djad127.
Currently, there are no data regarding the impact of treatment interruptions during radiotherapy for breast cancer. In this study, we examine the correlation between treatment interruptions during radiotherapy and outcomes in triple-negative breast cancer patients.
A total of 35 845 patients with triple-negative breast cancer treated between 2010 and 2014 were identified and analyzed from the National Cancer Database. The number of interrupted radiotherapy treatment days was calculated as the difference between the total elapsed days from the start to end of radiation treatment (both initial treatment and boost treatment, when boost was administered) and the total number of expected treatment days, defined as the number of expected treatment days with an addition of 2 weekend days for every multiple of 5 treatment days. Binomial multivariate regression analysis was used to detect correlates of treatment interruptions, and propensity-score matched multivariable Cox proportional hazard models were used to evaluate the association between treatment interruption and overall survival (OS).
When modeled as a continuous variable, longer treatment duration was associated with poorer OS (hazard ratio [HR] = 1.023, 95% confidence interval [CI] = 1.015 to 1.031). In reference to 0-1 days of interruption, patients with 2-5 interrupted days (HR = 1.069, 95% CI = 1.002 to 1.140 interrupted days), 6-10 interrupted days (HR = 1.239, 95% CI = 1.140 to 1.348 interrupted days), and 11-15 interrupted days (HR = 1.265, 95% CI = 1.126 to 1.431 interrupted days) experienced increasing likelihood of mortality.
In the first study of its kind, we report a correlation between treatment interruptions during adjuvant radiotherapy in triple-negative breast cancer and OS.
目前，尚无关于乳腺癌放疗过程中治疗中断对结果影响的数据。在本研究中，我们研究了三阴性乳腺癌患者放疗期间治疗中断与结果之间的相关性。
从国家癌症数据库中确定并分析了 2010 年至 2014 年期间治疗的 35845 例三阴性乳腺癌患者。将中断放疗治疗的天数计算为从开始到结束（初始治疗和加量治疗，如果进行了加量治疗）的总天数与总预计治疗天数之间的差异，预计治疗天数定义为每个 5 天治疗周期加上 2 个周末的天数的倍数。使用二项式多变量回归分析检测治疗中断的相关因素，并使用倾向评分匹配多变量 Cox 比例风险模型评估治疗中断与总生存（OS）之间的关系。
当作为连续变量建模时，较长的治疗时间与较差的 OS 相关（风险比[HR] = 1.023，95%置信区间[CI] = 1.015 至 1.031）。与 0-1 天的中断相比，中断 2-5 天（HR = 1.069，95%CI = 1.002 至 1.140 天）、中断 6-10 天（HR = 1.239，95%CI = 1.140 至 1.348 天）和中断 11-15 天（HR = 1.265，95%CI = 1.126 至 1.431 天）的患者死亡风险增加。
在同类研究中，我们首次报告了三阴性乳腺癌辅助放疗期间治疗中断与 OS 之间的相关性。
