乳腺癌全乳房切除术后单纯区域复发的放疗和预后分析

doi:10.3760/cma.j.cn113030-20201127-00573

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Abstract Objective To analyze the prognosis of patients with isolated regional recurrence (RR) after mastectomy, and evaluate the efficacy of radiotherapy and identify the optimal radiation target volumes. Methods Clinical data of 144 patients with first isolated RR after mastectomy between 2001 and 2018 were retrospectively analyzed. All patients had not received post-mastectomy radiotherapy. The primary endpoints consisted of the subsequent locoregional recurrence (sLRR), distant metastasis (DM), progression-free survival (PFS) and overall survival (OS). Results With a median follow-up of 82.5 months after RR, the 5-year sLRR, DM, PFS and OS rates for the entire group were 42.1%, 71.9%, 22.9% and 62.6%, respectively. Local plus systemic therapy was an independent favorable prognostic factor for sLRR (P<0.001) and PFS (P=0.013). The sLRR rate in the surgery plus radiotherapy group was the lowest (P<0.001). Surgery plus radiotherapy significantly reduced the 5-year risk of recurrence within the initially involved nodal regions (P<0.001). Patients with chest wall irradiation obtained the 5-year subsequent chest wall recurrence rate of 12.1% compared to 14.8%(P=0.873) for those without chest wall irradiation. The subsequent supraclavicular recurrence rate was lower in patients with prophylactic supraclavicular irradiation than that without prophylactic supraclavicular irradiation (9.9% vs. 23.8%, P=0.206). The incidence rates of initially uninvolved axillary and internal mammary nodal recurrence were below 10% regardless of prophylactic irradiation or not. Conclusions Patients with RR alone have an optimistic 5-year OS in the contemporary era. Comprehensive locoregional treatment including surgery and radiotherapy combined with systemic therapy is recommended. The chest wall, axillary and internal mammary nodal prophylactic irradiation should not be routinely performed for all patients with RR. The value of supraclavicular prophylactic irradiation remains to be evaluated.

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	Articles by authors
	Zhao Xuran
	Xuan Liang
	Yin Jun
	Tang Yu
	Sun Huiru
	Wu Shikai
	Jing Hao
	Fang Hui
	Song Yongwen
	Jin Jing
	Liu Yueping
	Ren Hua
	Chen Bo
	Qi Shunan
	Li Ning
	Tang Yuan
	Lu Ningning
	Yang Yong
	Li Yexiong
	Sun Bing
	Wang Shulian

Key words： Neoplasm recurrence,breast/radiotherapy Subsequent locoregional recurrence Prognosis

Received: 27 November 2020

Fund:Beijing Marathon of Hope, Cancer Foundation of China (LC2019L02);Special Research Fund for Central Universities, Peking Union Medical College(3332019054);Chinese Society of Clinical Oncology-Beijing Xisike Clinical Oncology Research Foundation(Y-2019sciclone-022)

Corresponding Authors: Wang Shulian, Email:wsl20040118@yahoo.com;Sun Bing, Email:sunice116@163.com

Cite this article:

Zhao Xuran,Xuan Liang,Yin Jun et al. Radiotherapy and prognostic analysis of breast cancer patients with isolated regional recurrence after mastectomy[J]. Chinese Journal of Radiation Oncology, 2021, 30(10): 1030-1035.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20201127-00573 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I10/1030

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