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首页> 外文期刊>Journal of geriatric oncology >Adjuvant radiation and outcomes after breast conserving surgery in publicly insured patients
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Adjuvant radiation and outcomes after breast conserving surgery in publicly insured patients

机译：公共保险患者在保乳手术后的辅助放射线和结局

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Objectives: Epidemiologic studies report that lack of adjuvant radiation (RT) after breast conserving surgery (BCS) is associated with higher short-term mortality. It is generally accepted that adjuvant RT decreases risk of breast cancer recurrence and thereby lowers long-term mortality; here, we explore reasons for its relationship to short-term mortality. Materials and Methods: We studied 1583 publically insured women who had BCS between 1998 and 2002 (mean 71.8. years, range 27-101), of whom 1346 (85%) received RT. Multivariate analyses with Cox Proportional Hazards and Logistic Regression models included: age; race; comorbidity; insurance status; tumor size; number of nodes positive; hormone receptor status; receipt of radiation; adjuvant chemotherapy; preventive care - including mammography, Pap smear and primary care visits; and hospitalization. Results: At a mean follow-up of 52.8. months, overall mortality was significantly lower in those who received RT (HR 0.45, p < 0.0001) and higher with older age (HR 1.05, p < 0.0001) and greater comorbidity (HR 1.16, p = 0.0007). Local recurrence was less with receipt of optimal radiation (HR 0.47; p = 0.03). Breast cancer event, as determined by a clinically logical algorithm to detect breast cancer recurrence and death, however, was not significantly associated with receipt of RT (OR 1.32, p = 0.2). Conclusion: These results imply that the higher short-term mortality in women not receiving RT after BCS is related to factors other than breast cancer recurrence.
机译：目的：流行病学研究报告说，保乳手术（BCS）后缺乏辅助放射（RT）与较高的短期死亡率有关。一般认为，辅助性放疗可降低乳腺癌复发的风险，从而降低长期死亡率。在这里，我们探讨了其与短期死亡率之间关系的原因。材料和方法：我们研究了1583名1998年至2002年间患有BCS的公共保险妇女（平均年龄71.8岁，范围27-101），其中1346名（85％）接受了RT。使用Cox比例风险和Logistic回归模型进行的多变量分析包括：年龄;种族;合并症保险状况;肿瘤大小;正节点数;激素受体状态;收到辐射;辅助化疗预防护理-包括乳房X线摄影，子宫颈抹片检查和基层医疗;和住院。结果：平均随访52.8。接受放疗的患者的总死亡率显着降低（HR 0.45，p <0.0001），而随着年龄的增长（HR 1.05，p <0.0001）和更高的合并症（HR 1.16，p = 0.0007）而更高。接受最佳放疗后局部复发较少（HR 0.47; p = 0.03）。然而，通过临床逻辑算法检测乳腺癌复发和死亡的乳腺癌事件与接受RT并没有显着相关性（OR 1.32，p = 0.2）。结论：这些结果表明，BCS后未接受RT的女性的较高短期死亡率与乳腺癌复发以外的其他因素有关。

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