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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Increased use of regional radiotherapy is associated with improved outcome in a population-based cohort of women with breast cancer with 1-3 positive nodes.
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Increased use of regional radiotherapy is associated with improved outcome in a population-based cohort of women with breast cancer with 1-3 positive nodes.

机译：在具有1-3个阳性淋巴结的乳腺癌女性人群中，增加区域放疗的使用与改善结局有关。

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PURPOSE: To examine use of and outcomes from adjuvant locoregional radiotherapy (LRRT) after breast-conserving surgery (BCS) for women with breast cancer with 1-3 positive nodes (1-3N+) before and after the 1997 publication of randomised trial evidence of a survival advantage from post-mastectomy LRRT. METHODS: Data were analysed for 2768 women diagnosed between 1989 and 2005 and referred to the British Columbia Cancer Agency with newly diagnosed pT1-3 breast cancer with 1-3N+, treated with BCS and RT. LRRT use was analysed over time. Ten-year Kaplan-Meier locoregional control (LRC), breast cancer-specific survival (BCSS) and overall survival (OS) curves were compared using the log-rank test. Cox regression modeling of LRC and BCSS were performed. RESULTS: LRRT use in patients with 1-3N+ increased from 23% before 1997 to 57% after 1997. LRRT was associated with significant improvements in LRC, but not in DRFS, BCSS, or OS. 10--year LRC was 89% with local RT alone and 93% with LRRT (p=0.006). On multivariable analysis, LRRT was associated with improved LRC compared to local RT alone (HR 0.55, 95% CI: 0.40-0.77), but not with significant BCSS differences. Margin status, grade, % positive nodes, and hormonal therapy were significant predictors for LRC, while tumour size, grade, % positive nodes, and hormonal therapy significantly affected BCSS. CONCLUSION: Post-BCS LRRT use in British Columbia increased almost threefold in patients with 1-3N+ after 1997. Adjuvant LRRT was associated with improved LRC, but not with improved BCSS compared to breast RT alone.
机译：目的：研究1997年随机对照试验证据发表前和后，对于有1-3个阳性淋巴结（1-3N +）的乳腺癌女性，在保乳手术（BCS）后进行局部局部放疗（LRRT）的使用和结果。乳房切除术后LRRT的生存优势。方法：分析了1989年至2005年间诊断为2768名妇女的数据，并将其转诊至不列颠哥伦比亚省癌症局，他们接受了新诊断的1-3N + pT1-3乳腺癌，接受了BCS和RT治疗。随着时间的推移分析了LRRT的使用。使用对数秩检验比较了十年Kaplan-Meier局部区域对照（LRC），乳腺癌特异性存活率（BCSS）和总体存活率（OS）曲线。进行了LRC和BCSS的Cox回归建模。结果：1-3N +患者使用LRRT的比例从1997年之前的23％增加到1997年之后的57％。LRRT与LRC的显着改善相关，但与DRFS，BCSS或OS无关。仅局部放疗的10年LRC为89％，而放疗为10年的LRC为93％（p = 0.006）。在多变量分析中，与单独的局部放疗相比，LRRT与改善的LRC相关（HR 0.55，95％CI：0.40-0.77），但与BCSS差异不明显。边缘状态，等级，阳性淋巴结百分比和激素治疗是LRC的重要预测指标，而肿瘤大小，等级，阳性淋巴结百分比和激素治疗显着影响BCSS。结论：在1997年以后，BCS后LRRT在1-3N +患者中的使用增加了将近三倍。与仅使用乳腺RT相比，辅助LRRT与LRC改善有关，但与BCSS改善无关。

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