CAJ | 학술논문

目的分析T1～2N1M0期三阴乳腺癌的局部复发风险和放疗作用.方法回顾分析1996-2010年间215例T1～2N1M0期三阴乳腺癌改良根治术患者资料,其中66例术后常规放疗、149例未放疗.比较两组生存率和局部区域复发率,并应用倾向评分配比法分析比较.结果中位随访时间为56个月.全组36例局部复发(16.7％).放疗比未放疗提高了5年LRRFS(92.6％和76.6％,P=0.010),两组OS相似(82.8％和84.7％,P=0.499),单因素预后分析显示放疗、T分期是LRRFS的影响因素.放疗与未放疗组倾向评分配对分析结果显示5年LRRFS也不同(92.6％和74.5％,P=0.008),多因素预后分析显示改良根治术后未放疗是局部区域复发的唯一影响因素(HR=3.53,95％ CI=1.153～10.844,P=0.027).结论 T1～2N1M0期三阴乳腺癌改良根治术后未放疗增加了局部复发风险,但还需前瞻性随机分组研究术后放疗带来的益处.
목적 분석T1～2N1M0기삼음유선암적국부복발풍험화방료작용.방법 회고분석1996-2010년간215례T1～2N1M0기삼음유선암개량근치술환자자료,기중66례술후상규방료、149례미방료.비교량조생존솔화국부구역복발솔,병응용경향평분배비법분석비교.결과 중위수방시간위56개월.전조36례국부복발(16.7％).방료비미방료제고료5년LRRFS(92.6％화76.6％,P=0.010),량조OS상사(82.8％화84.7％,P=0.499),단인소예후분석현시방료、T분기시LRRFS적영향인소.방료여미방료조경향평분배대분석결과현시5년LRRFS야불동(92.6％화74.5％,P=0.008),다인소예후분석현시개량근치술후미방료시국부구역복발적유일영향인소(HR=3.53,95％ CI=1.153～10.844,P=0.027).결론 T1～2N1M0기삼음유선암개량근치술후미방료증가료국부복발풍험,단환수전첨성수궤분조연구술후방료대래적익처.
Objective To evaluate the role of conventional radiotherapy following modified radical mastectomy for women with T1-2N1M0 triple-negative breast cancer (TNBC).Methods From 1996 to 2010,215 patients diagnosed with T1-2N1M0 TNBC were retrospectively analyzed.All patients were treated with modified radical mastectomy (MRM).Of them,66 patients received postmastectomy conventional radiotherapy and 146 patients did not.Locoregional recurrence-free survival (LRRFS) and overall survival (OS) were compared between two groups with or without propensity-score matching methods.Results With a median follow-up of 56 months,36 patients developed locoregional recurrence (LRR).The 5-year LRRFS and OS rates were 92.6％ and 82.8％ for MRM compared with 76.6％ (P =0.010) and 84.7 (P =0.499) for postmastectomy conventional radiotherapy,respectively.In multivariate analysis,MRM and T2 were associated with increased LRR.In matched-pair of radiotherapy and no radiotherapy using propensity-score matching methods,the 5-year LRRFS was 92.6％ for MRM plus RT compared with 74.5％ for MRM (P=0.008).Multivariate analysis indicated that no radiotherapy was the only independent prognostic factorassociated with increased LRR (HR =3.536,95％ CI =1.153-10.844 ;P =0.027).Conclusions Patients with T1-2 N1 M0 TNBC treated with MRM without RT appear to be at an increased risk for LBR compared with those treated with MRM and RT.Prospective studies are warranted to investigate the benefit of postmastectomy conventional radiotherapy to improve the outcome of patients in T1-2N1M0 TNBC.