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首页> 外文期刊>Journal of Cancer Research and Clinical Oncology >Older age and comorbidity in breast cancer: is RT alone the new therapeutic frontier?
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Older age and comorbidity in breast cancer: is RT alone the new therapeutic frontier?

机译：年龄和乳腺癌中的合并症：NO独自是新的治疗边缘吗？

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Aim To assess the impact of age, comorbidities and endocrine therapy (ET) in older breast cancer (BC) patients treated with hypofractionated radiotherapy (Hypo-RT). Methods From June 2009 to December 2017, we enrolled in this study 735 ER-positive BC patients (stage pT1-T2, pNx-1, M0 and age >= 65 years) receiving hypo-RT and followed them until September 2019. Baseline comorbidities included in the hypertension-augmented Charlson Comorbidity Index were retrospectively retrieved. Logistic regression model estimated adjusted-odds ratios (ORs) of ET prescription in relation to baseline patient and tumor characteristics. Competing risk analysis estimated 5-year cumulative incidence function (CIF) of ET discontinuation due to side effects (with BC progression or death as competing events), and its effect on locoregional recurrence (LRR) and distant metastasis (DM) (with death as competing event). Results ET has been prescribed in 89% patients. In multivariable analysis, the odds of ET prescription was significantly reduced in older patients (>= 80 years, OR 0.08, 95% CI 0.03-0.20) and significantly increased in patients with moderate comorbidity. Patients >= 80 years discontinued the prescribed therapy earlier and more frequently than younger (65-69 years) patients (p = 0.060). Five-year CIF of LLR, DM and death from causes other that BC were 1.7%, 2.2% and 7.5%, respectively. Patients who discontinued ET had higher chance of LRR (p = 0.004). ET use did not impact on OS in any of the analyzed groups. Conclusions In older patients, ET did not show a benefit in terms of overall survival. Further studies focusing on tailored treatment approaches are warranted to offer the best care in terms of adjuvant treatment to these patients.
机译：目的评估较少数乳腺癌（BC）患者的年龄，可血糖和内分泌治疗（ET）的影响（UPO-RT）。方法方法从2009年6月到2017年12月，我们注册了本研究735 ER-阳性BC患者（PT1-T2，PNX-1，M0和AGE> = 65岁）接受过HOT-RT并遵循2019年9月。基线合并症包含在高血压 - 增强的Charlson合并症中回顾性检索。估计与基线患者和肿瘤特征有关ET处方的逻辑回归模型估计调整 - 差距（或）。竞争风险分析估计，由于副作用（具有BC进展或死亡，作为竞争事件的BC进展或死亡），ET中断的5年累积发生率（CIF），及其对招诊所复发（LRR）和远处转移（DM）的影响（死亡为竞争事件）。结果ET已在89％的患者中规定。在多变量分析中，老年患者（> = 80岁或0.08,95％CI 0.03-0.20）显着降低了ET处方的几率显着降低，并且在中等合并症患者中显着增加。患者> = 80年代早期停产，比年轻（65-69岁）患者更频繁地（P = 0.060）。 LLR，DM和死亡的五年CIF，导致BC分别为1.7％，2.2％和7.5％。停止ET的患者有更高的LRR机会（P = 0.004）。 ET在任何分析的组中都不会影响OS。在老年患者中，ET在整体生存方面没有表现出益处。重点研究重点定制的处理方法是有必要在对这些患者的辅助治疗方面提供最佳护理。

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