保乳术后放疗开始时间对早期乳腺癌患者预后的影响

临床肿瘤学杂志 ›› 2018, Vol. 23 ›› Issue (9): 835-839.

保乳术后放疗开始时间对早期乳腺癌患者预后的影响

1 455002 河南安阳安阳市人民医院普外科

2 455002 安阳市人民医院放疗科

收稿日期:2018-05-28 修回日期:2018-07-12 出版日期:2018-09-30 发布日期:2018-11-28
通讯作者: 王姣平 E-mail:1101785187@qq.com

The time effect of radiotherapy after breast-conserving surgery in patients with early breast cancer

Department of General Surgery， Anyang People’s Hospital， Anyang 455002，China

Received:2018-05-28 Revised:2018-07-12 Online:2018-09-30 Published:2018-11-28
Contact: WANG Jiaoping E-mail:1101785187@qq.com

摘要/Abstract

摘要：

目的探讨早期乳腺癌患者行保乳术后放疗开始时间对预后的影响。方法回顾性分析2012年10月至2013年5月期间在我院接受保乳手术治疗的142例早期乳腺癌患者的临床病例资料，其中A组18例患者接受先放疗、后化疗；B组99例患者接受先化疗、后放疗；C组25例患者接受化疗-放疗-化疗夹心治疗，比较3组患者的临床病理特征以及无病生存时间（DFS）情况。采用递归分割（RPA）法对患者进行手术到放疗的分割时间点进行分层，比较DFS的差异。结果 142例患者5年无病生存率为81.69％。A组5年DFS为83.3％（15／18），B组为79.8％（79／99），C组为88.0％（22／25），3组差异无统计学意义。多因素Cox风险回归模型分析，年龄、脉管癌栓、N分期是影响5年无病生存率的独立因素（P＜0.05）。采用RPA法将患者分为手术至放疗时间间隔≤11周（n=53例）和＞11周（n=89例），两组患者5年无病生存率分别为90.6％和76.4％（P =0.389）。将先化疗组患者分为手术至放疗时间间隔≤23周（n=89例）和＞23周（n=35例），5年无病生存率分别为89.9％和60.0％（P＜0.05）。将先放疗组患者分为手术至放疗时间间隔≤4.8周（n=11例）和＞4.8周（n=7例），5年无病生存率分别为90.9％和71.4％（P =0.291）。结论保乳术联合术后放化疗对早期乳腺癌临床疗效良好，但是对于先化疗患者，建议尽早进行放疗，以改善患者预后。

关键词: 早期乳腺癌, 保乳术, 放射治疗, 无疾病生存, 手术-放疗时间间隔

Abstract:

Objective To investigate the effect of radiotherapy initiation time on prognosis of patients with early breast cancer after breast conserving surgery. Methods The clinical data of 142 patients with early breast cancer who underwent breast conserving surgery in our hospital from October 2012 to May 2013 were retrospectively analyzed， including 18 patients in group A received first radiotherapy and then chemotherapy； 99 patients in group B received first chemotherapy and then radiotherapy； 25 patients received chemotherapy-radiotherapy-chemotherapy sandwich therapy. The clinicopathological characteristics and disease-free survival （DFS） of the three groups were compared. Recursive partitioning analysis （RPA） was used to stratify the time points from surgery to radiotherapy， and the differences of DFS were compared. Results In 142 patients， 5-year DFS rate was 81.69％. 5-year DFS rate of group A， group B and group C was 83.3％（15／18），79.8％（79／99） and 88.0％（22／25）. There was no significant difference among the three groups. Multivariate COX risk regression analysis showed that age， vascular tumor thrombus and N stage were independent factors affecting 5-year DFS （P＜0.05）. The patients were divided into two groups by RPA： the interval between operation and radiotherapy was ≤11 weeks （n=53 cases） and ＞11 weeks （n=89 cases）. The 5-year DFS rates of the two groups were 90.6％ and 76.4％ respectively （P =0.389）. Patients in group B were divided into two groups： the interval between operation and radiotherapy was less than 23 weeks （n=89 cases） and more than 23 weeks （n=35 cases）. The 5-year DFS rates of the two groups were 89.9％ and 60.0％ respectively （P＜0.05）. Patients in group C were divided into operation to radiotherapy interval ＜4.8 weeks （n=11 cases） and ＞4.8 weeks （n=7 cases）， The 5-year DFS rates of the two groups 90.9％ and 71.4％ respectively （P =0.291）. Conclusion Breast conserving surgery combined with postoperative radiotherapy and chemotherapy has a good clinical effect on early breast cancer， but radiotherapy is recommended as early as possible to improve the prognosis of patients with chemotherapy.

Key words: Early breast cancer, Breast conservative surgery, Radiotherapy, Disease-free survival, Time interval surgery and radiation

牛增志, 王姣平, 何佳欣.

保乳术后放疗开始时间对早期乳腺癌患者预后的影响 [J]. 临床肿瘤学杂志, 2018, 23(9): 835-839.

NIU Zengzhi, WANG Jiaoping, HE Jiaxin..

The time effect of radiotherapy after breast-conserving surgery in patients with early breast cancer [J]. Chinese Clinical Oncology, 2018, 23(9): 835-839.

参考文献

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

本文评价

推荐阅读 10

[1]	刘锦；李贵新；马传香. 恶性黑色素瘤腹腔转移１例[J]. 临床肿瘤学杂志, 2009, 14(1): 96 .
[2]	石　玮¹，华海清²，王兴华¹. 放疗对肠屏障功能的影响及研究进展[J]. 临床肿瘤学杂志, 2009, 14(1): 89 .
[3]	王杰军，李　睿. ＮＣＣＮ成人癌痛临床实践指南解读[J]. 临床肿瘤学杂志, 2009, 14(1): 80 .
[4]	崔传亮，迟志宏，袁香庆，斯　璐，盛锡楠，郭　军. 重组人血管内皮抑制素联合化疗一线治疗晚期黑色素瘤的Ⅱ期临床研究[J]. 临床肿瘤学杂志, 2009, 14(1): 74 .
[5]	白秀丽¹，马振刚¹，李际君². 紫杉醇联合卡培他滨治疗进展期胃癌的临床观察[J]. 临床肿瘤学杂志, 2009, 14(1): 68 .
[6]	徐卫国¹，杨小青²，郝世柱¹，宋纪宁¹，张鹏东¹，胡潺潺¹，王文雅¹. 大肠癌组织中Ｎｅｕｒｏｐｉｌｉｎ-１的表达及其与肿瘤血管生成的相关性研究[J]. 临床肿瘤学杂志, 2009, 14(1): 29 .
[7]	许景艳¹，欧阳建^１，章宜芬²，周荣富¹，陈　兵¹，张启国¹，杨永公¹，邵小雁¹，徐　勇¹，关朝阳¹. 原发性肋骨血管肉瘤的诊治探讨[J]. 临床肿瘤学杂志, 2009, 14(1): 70 .
[8]	徐晓明¹，唐金海¹，刘万花²，郑凯尔²，秦建伟¹，赵祥生¹，张　彤³. 触诊阴性乳腺癌的定位方法与同期手术治疗[J]. 临床肿瘤学杂志, 2009, 14(1): 43 .
[9]	张艳玲，邹　岚，肖　红，黄海辉，谭崇富，阮志华，王　希，梁后杰，庞学利. 影像引导调强放射治疗鼻咽癌[J]. 临床肿瘤学杂志, 2009, 14(1): 51 .
[10]	翟云芝¹，陈振东²，秦凤展¹. Ｅｚｒｉｎ和ＡＫＴ２在大肠癌组织中的表达及其临床意义[J]. 临床肿瘤学杂志, 2009, 14(1): 25 .