早期(T1-2N1)三阴型乳腺癌根治术后辅助放疗的疗效评估  

Evaluation of the Curative Effects of Post-Mastectomy Radiotherapy for Early(T1-2N1)Triple Negative Breast Cancer

作　　者：刘靖宜 苏宁 李妍 石梅 Liu Jingyi;Su Ning;Li Yan;Shi Mei(Department of Radiation Oncology,First Affiliated Hospital of Air Force Military Medical University,XV an 710032,Shaanxi,China)

机构地区：[1]空军军医大学第一附属医院放疗科,西安710032

出　　处：《肿瘤预防与治疗》2022年第1期14-22,共9页Journal of Cancer Control And Treatment

基　　金：国家自然科学基金(编号:81801300)。

摘　　要：目的:评估乳腺癌根治术后放疗(post-mastectomy radiationtherapy,PMRT)在早期(T1-2N1)三阴型乳腺癌(triplen egative breast cancer,TNBC)患者中的治疗价值。方法:回顾性分析SEER数据库中根治术后早期(pT1-2N1)TNBC患者的临床数据。将患者分为根治术后放疗(PMRT)组和无放疗(non-PMRT)组。平衡两组患者的基线特征,比较两组患者的总生存时间(overall survival,OS)和乳腺癌特异性生存时间(breast cancer-specific survival,BCSS)。通过单多因素Cox分析确定早期TNBC患者的预后因素。进行亚组分析,筛选出PMRT的获益人群。结果:患者的中位随访时间为51个月。PMRT组及non-PMRT组5年总生存率分别为76.17%和72.96%(P=0.266),5年BCSS分别为79.67%和76.92%(P=0.249),PMRT并不能改善早期TNBC患者的OS(P=0.095)及BCSS(P=0.102)。亚组分析发现,PMRT仅可改善T2N1期患者的OS(P=0.005)及BCSS(P=0.021),PMRT组5年总生存率为75.18%,non-PMRT组为65.28%(P=0.032),5年BCSS分别为77.39%和67.45%(P=0.040)。结论:在早期TN-BC患者中,对T2N1期患者可予以辅助PMRT以提高生存,对T1N1期患者则不建议进行辅助PMRT。Objective:To evaluate the therapeutic value of post-mastectomy radiotherapy(PMRT)in patients with early(pT1-2N1)triple-negative breast cancer(TNBC).Methods:The clinical data of early TNBC patients after mastectomy in the SEER database were retrospectively analyzed.Patients were assigned to the PMRT group and the non-PMRT group.After propensity score matching,overall survival(OS)and breast cancer-specific survival(BCSS)were compared between the two groups.Univariate and multivariate Cox analyses were used to determine the prognostic factors of early TNBC patients.Subgroup analysis was further carried out to screen out the benefited population of PMRT.Results:The median follow-up time was 51 months.The 5-year OS rates were 76.17% and 72.96%(P=0.266)in the PMRT group and the non-PMRT group,and the 5-year BCSS rates were 79.67% and 76.92%(P=0.249).PMRT did not improve OS(P=0.095)and BCSS(P=0.102)in early TNBC patients.In subgroup analysis,it was found that PMRT only improved OS(P=0.005)and BCSS(P=0.021)in T2N1 patients.The 5-year OS rate was 75.18% in the PMRT group,and 65.28% in the non-PMRT group(P=0.032);and the 5-year BCSS rates were 77.39% and 67.45%(P=0.040).Conclusion:In patients with early(T1-2N1)TNBC,PMRT is recommended for T2N1 patients,which can improve survival.PMRT is not recommended for T1N1 patients.

关 键 词：三阴型乳腺癌 根治术后放疗 生存分析 SEER数据库 

分 类 号：R730.7[医药卫生—肿瘤] R737.9[医药卫生—临床医学]