CAJ | 학술논문

目的：探讨65岁以上老年乳腺癌患者的治疗方式及影响因素。方法收集2009年1月至2010年12月间手术治疗的126例65岁以上老年乳腺癌患者的临床资料，记录患者年龄、治疗方式、临床病理特点、合并症和生存率等，分析其治疗方式的差异及其影响因素。结果126例患者按年龄分为65～74岁组和＞74岁组，其中65～74岁组71例，＞74岁组55例。65～74岁组和＞74岁组患者的手术方式主要为改良根治术（分别为84．5％和89．1％），接受术后辅助化疗的比例分别为73．2％和54．5％，接受内分泌治疗的比例分别为67．6％和61．8％，接受术后放疗的比例分别为19．7％和7．3％。老年乳腺癌的化疗与患者年龄、病理类型、孕激素受体（ PR）表达情况和有无合并症有关，老年乳腺癌的放疗与患者年龄、手术方式、TNM分期、淋巴结转移情况有关（均P＜0．05）。多因素分析显示，患者年龄、病理类型、PR表达情况和有无合并症为老年乳腺癌化疗的独立影响因素（均P＜0．05），患者年龄和手术方式为老年乳腺癌放疗的独立影响因素（均P＜0．05）。126例老年乳腺癌患者的3年无复发生存率和3年总生存率分别为91．3％和92．0％，其中内分泌治疗与老年乳腺癌患者的3年无复发生存率有关（P＝0．038），年龄与老年乳腺癌患者的3年总生存率有关（P＝0．037）。结论65岁以上老年乳腺癌患者的手术及内分泌治疗方式不受年龄影响；术后辅助化疗及放疗的比例随患者年龄的增加而降低，这与患者的病理类型、PR表达、手术方式及合并症等有关；老年乳腺癌患者的3年生存率仅与年龄有关。
목적：탐토65세이상노년유선암환자적치료방식급영향인소。방법수집2009년1월지2010년12월간수술치료적126례65세이상노년유선암환자적림상자료，기록환자년령、치료방식、림상병리특점、합병증화생존솔등，분석기치료방식적차이급기영향인소。결과126례환자안년령분위65～74세조화＞74세조，기중65～74세조71례，＞74세조55례。65～74세조화＞74세조환자적수술방식주요위개량근치술（분별위84．5％화89．1％），접수술후보조화료적비례분별위73．2％화54．5％，접수내분비치료적비례분별위67．6％화61．8％，접수술후방료적비례분별위19．7％화7．3％。노년유선암적화료여환자년령、병리류형、잉격소수체（ PR）표체정황화유무합병증유관，노년유선암적방료여환자년령、수술방식、TNM분기、림파결전이정황유관（균P＜0．05）。다인소분석현시，환자년령、병리류형、PR표체정황화유무합병증위노년유선암화료적독립영향인소（균P＜0．05），환자년령화수술방식위노년유선암방료적독립영향인소（균P＜0．05）。126례노년유선암환자적3년무복발생존솔화3년총생존솔분별위91．3％화92．0％，기중내분비치료여노년유선암환자적3년무복발생존솔유관（P＝0．038），년령여노년유선암환자적3년총생존솔유관（P＝0．037）。결론65세이상노년유선암환자적수술급내분비치료방식불수년령영향；술후보조화료급방료적비례수환자년령적증가이강저，저여환자적병리류형、PR표체、수술방식급합병증등유관；노년유선암환자적3년생존솔부여년령유관。
Objective To explore different therapies and affecting factors in breast cancer patients≥65 years old.Methods To retrospectively analyze the clinical characteristics , treatments, comorbidity and survival rate of 126 female breast cancer patients over 65 years old who underwent surgical operation in our hospital from January 2009 to December 2010.To compare and analyze the differences in the treatment patterns, and find out the affecting factors .Results One hundred and twenty-six cases were included in this retrospective study , and they were divided into two groups according to age:65-74 years old group (71 cases) and >74 years group (55 cases).Most patients in the two groups received modified radical mastectomy (84.5%and 89.1%);73.2%and 54.5%of patients received adjuvant chemotherapy in the two groups, respectively.67.6% and 61.8% of the patients had adjuvant endocrine therapy respectively . 19.7% and 7.3%of the patients received radiotherapy , respectively.Chemotherapy in elderly breast cancer patients was correlated with age , pathological types , progesterone receptor ( PR ) status and comorbidity . Radiotherapy in elderly breast cancer patients was related to age , surgeical patterns , TNM stage and lymph node status.Multivariate analysis showed that age , pathological types , PR expression and comorbidity were independent factors affecting choice of chemotherapy in elderly breast cancer patients (P<0.05 for all). Age and surgical patterns were independent factors affecting choice of radiotherapy (P<0.05 for all).The 3-year disease-free survival ( DFS) rate and overall survival ( OS) rate in these patients were 91.3% and 92.0%, respectively.Furthermore, endocrine therapy was related to 3-year DFS rate (P=0.038) and age was correlated with 3-year OS rate (P=0.037) in these elderly patients.Conclusions Breast cancer in the elderly patients receive similar surgery and endocrine therapy , but the elderly patients are less likely to have chemotherapy and radiotherapy , due to age , PR expression , pathological types , surgical patterns and comorbidity.Only age contributes to the lower 3-year overall survival rate in >74-year old patients.