基于SEER数据库分析放疗对初诊Ⅳ期保乳术后乳腺癌患者预后的影响  

Effect of radiotherapy on prognosis of initially diagnosed stage Ⅳ breast cancer patients after breast-conserving surgery based on SEER database

作　　者：牟德武 孟朔 陈茂山[1] 杨磊[1] 杨宏伟[1] MU Dewu;MENG Shuo;CHEN Maoshan;YANG Lei;YANG Hongwei(Department of Breast and Thyroid Surgery,Suining Central Hospital,Suining,Sichuan 629000,China;Department of Imaging,Zhengzhou Orthopaedic Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]遂宁市中心医院乳腺甲状腺外科,四川遂宁629000 [2]郑州市骨科医院影像科,河南郑州450000

出　　处：《中国医学工程》2021年第10期6-11,共6页China Medical Engineering

基　　金：超声医学工程国家重点实验室面上项目(2020KFKT011)。

摘　　要：目的探讨放疗对初诊Ⅳ期接受保乳术乳腺癌患者预后的影响。方法提取美国SEER数据库中2010年至2018年初诊Ⅳ期乳腺癌患者病理资料,采用Kaplan-Meier生存分析、Log-rank检验及Cox风险比例模型分析放疗与初诊Ⅳ期保乳术后乳腺癌患者总生存(OS)的关系,根据患者不同特征行亚组分析。结果共纳入773例患者,其中放疗组381例(49.29%),未放疗组392例(50.71%);中位年龄58岁(四分位距:49~67岁);总死亡328例,其中放疗组140例(42.68%),未放疗组188例(57.32%)。多因素Cox风险比例模型分析结果显示,在总体人群中,放疗组OS优于未放疗组(OR=0.74,95%CI:0.60~0.92,P=0.008)。亚组分析显示,在年龄≤60岁、HR(-)/HER2(-)、单纯骨转移及化疗人群中放疗进一步改善患者OS。结论放疗可能提高部分接受保乳术的初诊Ⅳ期乳腺癌患者的总生存时间,肿瘤负荷较轻、预期生存时间较长的患者可能是放疗获益的主要人群。【Objective】 To investigate the effect of radiotherapy on the prognosis of initially diagnosed stage Ⅳ breast cancer patients who underwent breast conserving surgery. 【Methods】 The pathological data of breast cancer patients diagnosed with Ⅳ in 2010-2018 years were extracted from the US SEER database. Kaplan-Meier survival analysis, log-rank test and Cox risk ratio model were used to analyze the relationship between radiotherapy and overall survival(OS) of initially diagnosed stage Ⅳ breast cancer patients who underwent breast conserving surgery. Subgroup analysis based on different characteristics of patients was conducted.【Results】 A total of 773 patients were enrolled, including 381(49.29%) in the radiotherapy group and 392(50.71%) in the nonradiotherapy group;the median age was 58 years(interquartile range: 49 to 67 years);328 cases died, including 140 cases(42.68%)in the radiotherapy group and 188 cases(57.32%) in the non-radiotherapy group. The multivariate Cox risk ratio model analysis showed that in the overall population, the OS of the radiotherapy group was better than that of the non-radiotherapy group(OR=0.74, 95 CI: 0.60-0.92, P=0.008). Subgroup analysis showed that radiotherapy further improved OS in patients ≤60 years old, HR(-)/HER2(-), simple bone metastasis, and chemotherapy. 【Conclusion】 Radiotherapy may increase the overall survival time of some newly diagnosed Ⅳ stage breast cancer patients undergoing breast conserving surgery. Patients with lighter tumor load and longer survival time may be the main group of patients who benefit from radiotherapy.

关 键 词：晚期乳腺癌 放疗 预后 SEER数据库 

分 类 号：R737.9[医药卫生—肿瘤] R730.55[医药卫生—临床医学]