■该研究旨在探讨保乳手术(BCS)后辅助放疗(RT)在老年女性早期乳腺癌(BC)中的作用。
■70-79岁的BC患者,T1-2N0-1M0期,接受BCS在监测中进行筛查,2010年至2015年的流行病学和最终结果(SEER)数据库。临床病理特征采用倾向评分匹配(PSM)法进行平衡。进行Kaplan-Meier曲线和Cox回归分析以确定辅助RT对BC患者的影响。
■最终,12,310例接受辅助RT治疗的患者和4837例未接受RT治疗的患者,参与了分析。总的来说,接受辅助RT治疗的患者与更好的乳腺癌特异性生存率(BCSS)相关(HR:1.980[1.5996-2.456],P<0.001)和总生存期(OS)(HR:2.214[1.966-2.494],P<0.001)比那些没有接受RT的人。1:1PSM后,佐剂RT在两个BCSS中仍然具有优势(HR:1.918[1.439-2.557],P<0.001)和OS(HR:2.235[1.904-2.624],P<0.001)。在BCSS的多变量COX分析中,寡妇,离婚和分居的病人,肿瘤III级,T2阶段,N1级,没有RT,管腔B和三阴性的分子亚型与较短的BCSS相关(P<0.05)。在OS的多变量COX分析中,年龄≥74岁,寡妇,离婚和分居的病人,肿瘤II/III级,T2阶段,没有RT,没有化疗,三阴性的分子亚型与较短的OS相关(P<0.05)。此外,在所有亚组分析中观察到佐剂RT的优势。
■BCS后辅助RT可改善老年早期BC患者的BCSS和OS。此外,所有亚组分析得出的BCSS和OS均支持RT.
UNASSIGNED: The study aimed to explore the role of adjuvant radiotherapy (RT) after breast-conserving surgery (BCS) in elder women with early-stage breast cancer (BC).
UNASSIGNED: BC patients with 70-79 years of age, stage T1-2N0-1M0, undergoing BCS were screened in the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2015. The clinicopathological characteristics were balanced with propensity-score matching (PSM) method. Kaplan-Meier curves and Cox regression analyses were performed to determine the impact of adjuvant RT on BC patients.
UNASSIGNED: Ultimately, 12,310 patients treated with adjuvant RT and 4837 patients treated with no RT, were involved in the analysis. Overall, patients treated with adjuvant RT was associated with a better breast cancer-specific survival (BCSS) (HR: 1.980 [1.596- 2.456], P < 0.001) and overall survival (OS) (HR: 2.214 [1.966- 2.494], P < 0.001) than those who did not undergo RT. After 1:1 PSM, adjuvant RT still performed advantage in both BCSS (HR: 1.918 [1.439- 2.557], P < 0.001) and OS (HR: 2.235 [1.904- 2.624], P < 0.001). In the multivariate COX analysis of BCSS, widowed, divorced and separated patients, tumor grade III, T2 stage, N1 stage, no RT, molecular subtypes with luminal B and triple negative were associated with a shorter BCSS (P < 0.05). In the multivariate COX analysis of OS, age ≥74 years, widowed, divorced and separated patients, tumor grade II/III, T2 stage, no RT, no chemotherapy, molecular subtypes with triple negative were associated with a shorter OS (P < 0.05). Furthermore, the advantages of adjuvant RT were observed in all subgroup analysis.
UNASSIGNED: Adjuvant RT after BCS can improve both BCSS and OS in elderly patients with early-stage BC. Additionally, all subgroups analysis-derived BCSS and OS were in support of RT.