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乳腺癌保乳手术后60岁以上女性省略放疗在局部复发方面非劣效性:一项回顾性队列研究

Omission of Radiotherapy in Women >60 Years Old After Breast Conserving Surgery for Breast Cancer is Non-Inferior in Terms of Local Recurrence: A Retrospective Cohort Study.

作者信息

Sachoulidou Anna, Apostolidou Fani, Fronis Charalambos, Misailidou Despoina, Bozoglou Aichan, Tataridou Themis Anastasia, Ampatzoglou Aristomenis, Galanis Ioannis

机构信息

Second Department of Propaedeutic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessalonik, Thessalonik, Greece.

出版信息

Eur J Breast Health. 2023 Dec 27;20(1):38-44. doi: 10.4274/ejbh.galenos.2023.2023-9-5. eCollection 2024 Jan.

Abstract

OBJECTIVE

Local recurrence rate may show no significant differences between women aged 60 and older who receive breast-conserving surgery followed by radiotherapy and those in the same age group who undergo breast-conserving surgery without subsequent radiotherapy.

MATERIALS AND METHODS

Retrospective cohort study from a single practice with median follow-up time 44 months (interquartile range: 16, 82), comparing women older than 60 years old at diagnosis of breast cancer, treated with breast conserving surgery and either receiving or not receiving radiation therapy postoperatively. The primary endpoint was local recurrence difference between the two groups.

RESULTS

Local recurrence did not differ significantly between the two groups in terms of radiotherapy or not [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.89-1.02, Fisher's exact test = 0.388], nor between two age groups with cut-off at 65 years of age (OR: 0.99, 95% CI 0.92-1.07, Fisher's Exact test = 0.6). Local recurrence also did not differ when subgroups of age (60-65 years and >66 years) were considered. All patients received 5 years of hormonal therapy.

CONCLUSION

Omission of radiotherapy in selected patients is not inferior to radiotherapy after breast conserving surgery in terms of preventing local recurrence.

摘要

目的

对于接受保乳手术加放疗的60岁及以上女性与接受保乳手术但未进行后续放疗的同年龄组女性,局部复发率可能无显著差异。

材料与方法

一项来自单一医疗机构的回顾性队列研究,中位随访时间为44个月(四分位间距:16, 82),比较确诊为乳腺癌时年龄大于60岁、接受保乳手术且术后接受或未接受放射治疗的女性。主要终点是两组之间的局部复发差异。

结果

两组在是否接受放疗方面局部复发无显著差异[比值比(OR)0.96,95%置信区间(CI)0.89 - 1.02,Fisher精确检验 = 0.388],在以65岁为分界点的两个年龄组之间也无显著差异(OR:0.99,95% CI 0.92 - 1.07,Fisher精确检验 = 0.6)。当考虑年龄亚组(60 - 65岁和>66岁)时,局部复发也无差异。所有患者均接受了5年的激素治疗。

结论

在预防局部复发方面,对选定患者省略放疗并不劣于保乳手术后放疗。

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