背景:乳腺癌是一种疾病,在一个多世纪以来,在不同的假设和证据的影响下,随着时间的推移,治疗策略发生了变化。我们根据分期进行分类,分析放疗对无病生存期和总生存期的贡献,1-3淋巴结受累,和分子亚组。
方法:在机构审查委员会批准后,我们回顾了1999年7月至2020年12月期间进入大学医学院放射肿瘤学和内科肿瘤学系的乳腺癌患者的记录.使用数据倾向评分,使用最佳匹配算法(最佳,1:1).使用Kaplan-Meier方法计算倾向评分匹配后的无病生存率和总生存率。使用单变量和多变量Cox回归分析来估计风险比。
结果:在放疗和非放疗组中,无病生存率为257.42±5.46(246.72-268.13),分别为208,96±8,15(192,97-224,94)个月,(p=<0.001),总生存期为272,46±8,68(255,43-289,49),分别为21905±732(20470-23341)个月(p=0.002)。我们比较了接受放疗的19例N1患者组和未接受放疗的19例患者的无病生存时间分别为202,21±10,50(181,62-222,79)和148,82±24,91(99,99-197,65)个月(p=.011),总生存时间分别为200,85±12,79(175,77-225,92)和166,90±20,039(我们根据LuminalA检查了两组的无病生存期和总生存期,管腔B,TNBC,和HER2富集亚组。在管腔B亚组中,接受放疗和未接受放疗组的无病生存期分别为264.83±4.95(255.13-274.54)和187.09±11.06(165.41-208.78)个月(p<.001),总生存时间分别为252.29±10.54(231.62-272.97)和197.74±9.72(178.69-216.80)个月(p=.001)。
结论:由于研究证明,由于减少局部复发和全身转移率,RT可提高乳腺癌的长期生存率,据了解,频谱假说是迄今为止最准确地描述乳腺癌的假说。我们发现,与其他亚组相比,LuminalB浸润性乳腺癌患者从RT中受益更多。
BACKGROUND: Breast cancer has been a disease in which treatment strategy has changed over time under the influence of different hypotheses and evidence for more than a century. We analyzed the contribution of radiotherapy to disease-free survival and overall survival by classifying according to stage, 1-3 lymph node involvement, and molecular subgroups.
METHODS: Following the approval of the Institutional Review Board, records of patients with breast cancer who were admitted to University School of Medicine Departments of Radiation Oncology and Medical Oncology between July 1999 and December 2020 were reviewed. Using data propensity score matching was performed between the groups that did and did not receive radiotherapy using an optimal matching algorithm (optimum, 1:1). Disease-free survival and overall survival after propensity score matching were calculated using the Kaplan-Meier method. Univariate and multivariate Cox regression analysis was used to estimate hazard ratios.
RESULTS: In the radiotherapy and non-radiotherapy groups, disease-free survival was 257.42 ± 5.46 (246.72- 268.13), 208,96 ± 8,15 (192,97-224,94) months respectively, (p = < 0.001), overall survival was 272,46 ± 8,68 (255,43-289,49), 219,05 ± 7,32 (204,70-233,41) months respectively (p = .002). We compared the 19 N1 patient groups who received radiotherapy with the 19 patients who did not receive radiotherapy and calculated the disease-free survival times was 202,21 ± 10,50 (181,62-222,79) and 148,82 ± 24,91 (99,99-197,65) months respectively (p = .011) and overall survival times was 200,85 ± 12,79 (175,77-225,92) and 166,90 ± 20,39 (126,93-206,82) months respectively (p = .055). We examined disease-free survival and overall survival times in both groups according to Luminal A, Luminal B, TNBC, and HER2-enriched subgroups. In the Luminal B subgroup, the disease-free survival duration in the groups receiving radiotherapy and not receiving radiotherapy was 264.83 ± 4.95 (255.13-274.54) and 187.09 ± 11.06 (165.41-208.78) months (p < .001), and overall survival times were 252.29 ± 10.54 (231.62-272.97) and 197.74 ± 9.72 (178.69-216.80) months (p = .001) respectively.
CONCLUSIONS: Thanks to studies proving that RT increases long-term survival rates in breast cancer as a result of reducing locoregional recurrence and systemic metastasis rates, it has been understood that the spectrum hypothesis is the hypothesis that most accurately describes breast cancer to date. We found that patients with Luminal B invasive breast cancer benefited significantly more from RT compared to other subgroups.