摘要
目的探讨中高危老年（≥65岁）乳腺癌患者改良根治术后放疗（PMRT）的意义。方法收集874例改良根治术后中高危乳腺癌患者的临床资料，回顾性分析不同年龄组患者接受PMRT的情况和PMRT的作用，其中T3～T4和（或）N2～N3为高危组，T1～T2N1为中危组。结果i〉65岁的患者108例，占12．4％。与〈65岁的患者相比，≥65岁的患者中，病理学分级为Ⅲ级、N3、高危和化疗患者所占的比例低，而合并其他疾病和有恶性肿瘤史者所占的比例高。≥65岁的患者中，中危组和高危组患者接受放疗的比例分别为15．3％和52．2％；〈65岁的患者中，中危组和高危组患者接受放疗的比例分别为18．1％和82．7％。≥65岁的患者中，中危组放疗和未放疗者的5年局部区域复发率分别为0和14．2％（P=0．242），5年总生存率分别为100％和75．2％（P=0．159）；高危组放疗和未放疗者的5年局部区域复发率分别为0和14．1％（P=0．061），5年总生存率分别为84．6％和77．4％（P=0．597）。〈65岁的患者中，中危组放疗和未放疗者的5年局部区域复发率分别为0和9．9％（P=0．035），5年总生存率分别为87．0％和82．1％（P=0．739）；高危组放疗和未放疗者的5年局部区域复发率分别为7．2％和26．1％（P=0．000），5年总生存率分别为79．2％和57．7％（P=0．000）。结论不同年龄的中危组患者实施PMRT的比例相仿，但对于高危组患者，接受PMRT的比例随着患者年龄的增长而降低。高危老年乳腺癌患者实施PMRT可能可以降低局部区域复发率，应支持放疗。
Objective To analyze the role of postmastectomy radiotherapy （PMRT） in moderate- and high-risk elderly breast cancer patients. Methods The clinicopathological data of 874 breast cancer patients treated with mastectomy and axillary dissection were retrospectively analyzed. The T1-2N1 patients were defined as moderaterisk （IR） group, and T3-4 and/or N2-3 cases as high-risk （HR） group. The locoregional recurrence （LRR） and overall survival （OS） rates were calculated and compared according to different age groups and radiotherapy status. Kaplan-Meier method and Log-rank test was used for calculation and comparison of the survival curves of different patient groups. Results The median follow up time was 47 months. 108（12.4% ）patients were I〉65 years. For patients who were 〈65 and ≥65 years, 18.1% and 15.3% received PMRT in the IR group, and 82.7% and 52.2% received PMRT in the HR group, respectively. For patients ≥65 years, the 5-year LRR rates were 0% and 14.2% （P =0.242） and 5-year OS rates were 100% and 75.2% （P = 0. 159） for the PMRT-IR and non-PMRT-IR groups, respectively. The 5-year LRR rates were 0% and 14.1% （P = O. 061 ） , 5-year OS rates were 84.6% and 77.4% （P = 0. 597） for the PMRT-HR and non-PMRT-HR groups, respectively. For patients 〈 65 years, the 5-year LRR rates were 0% and 9.9% （ P = 0.035 ） and 5-year OS rates were 87.0% and 82.1% （P = 0.739） for the PMRT-IR and non-PMRT-groups, respectively. The 5-year LRR rates were 7.2% and 26.1% （P = 0.000） , 5-year OS rates were 79.2% and 57.7% （P =0.000） for the PMRT-HR and non-PMRT-HR groups, respectively. Conclusion With the increasing of age, there is a trend of decreasing use of postmastectomy radiotherapy in high-risk breast cancer patients. Postmastectomy radiotherapy can improve the locoregional control for high-risk patients and maybe considered even for those who are ≥65 years.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2009年第11期863-866,共4页
Chinese Journal of Oncology
