目的:乳腺恶性叶状肿瘤(MPTB)是一种罕见的乳腺癌,发病率低于1%。辅助放疗(RT)对MPTB的价值一直存在争议。本研究旨在探讨放疗对不同年龄女性MPTB患者长期生存的影响。
方法:从监测中选择女性MPTB患者,流行病学,和2000年至2020年的最终结果(SEER)数据库。采用Kaplan-Meier生存分析探讨RT对不同年龄组MPTB患者长期生存的价值。此外,我们对MPTB患者的总生存期(OS)和乳腺癌特异性生存期(BCSS)进行了单变量和多变量Cox回归分析.此外,还进行了倾向评分匹配(PSM)以平衡基线特征的差异.
结果:本研究纳入了2261例MPTB患者,包括455例(20.12%)RT患者和1806例(79.88%)无RT患者。根据年龄将这些患者分为4组:18-45、46-55、56-65和65-80。调整前,在年轻年龄组(18~45岁年龄组:OSP=0.019,BCSSP=0.016;46~55岁年龄组:OSP<0.001,BCSSP<0.001)中,接受RT治疗和未接受RT治疗的患者的长期生存率差异有统计学意义.PSM之后,无论是否接受RT,年轻组和老年组患者的长期生存率均无差异(18~45岁年龄组:OSP=0.473,BCSSP=0.750;46~55岁年龄组:OSP=0.380,BCSSP=0.816;56~65岁年龄组:OSP=0.484,BCSSP=0.290;66~80岁年龄组:0.7OSP=0.997,CSS).在多变量COX回归分析中,RT不影响MPTB患者的长期生存。
结论:没有证据表明特定年龄段的MPTB患者的长期生存可以从RT中受益。
OBJECTIVE: Malignant phyllodes tumor of the breast (MPTB) is a rare type of breast cancer, with an incidence of less than 1%. The value of adjuvant radiotherapy (RT) for MPTB has been controversial. The aim of the
study was to explore the effect of radiotherapy on the long-term survival of female patients with MPTB at different ages.
METHODS: Female MPTB patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2020. A Kaplan-Meier survival analysis was conducted to investigate the value of RT for the long-term survival of MPTB patients in different age groups. Additionally, univariate and multivariate Cox regression analyses were performed for overall survival (OS) and breast cancer-specific survival (BCSS) of MPTB patients. Furthermore, propensity score matching (PSM) was also performed to balance the differences in baseline characteristics.
RESULTS: 2261 MPTB patients were included in this
study, including 455 patients (20.12%) with RT and 1806 patients (79.88%) without RT. These patients were divided into four cohorts based on their ages: 18-45, 46-55, 56-65, and 65-80. Before adjustment, there was a statistically significant difference in long-term survival between RT-treated and non-RT-treated patients in the younger age groups (age group of 18-45 years: OS P = 0.019, BCSS P = 0.016; age group of 46-55 years: OS P < 0.001, BCSS P < 0.001). After PSM, no difference was found in long-term survival of patients in both younger and older groups regardless of whether they received RT (age group of 18-45 years: OS P = 0.473, BCSS P = 0.750; age group of 46-55 years: OS P = 0.380, BCSS P = 0.816, age group of 56-65 years: OS P = 0.484, BCSS P = 0.290; age group of 66-80 years: OS P = 0.997, BCSS P = 0.763). In multivariate COX regression analysis, RT did not affect long-term survival in patients with MPTB.
CONCLUSIONS: There is no evidence that long-term survival of MPTB patients in specific age groups can benefit from RT.