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