Survival following radiotherapy in young women with localized early-stage breast cancer according to molecular subtypes
Survival following radiotherapy in young women with localized early-stage breast cancer according to molecular subtypes
复制标题
根据分子亚型，患有局部早期乳腺癌的年轻女性放射治疗后的生存率
DOI：
10.1002/cam4.2186
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发表时间：
2019-06-01
期刊：
影响因子：
4
通讯作者：
Jin, Wei
中科院分区：
文献类型：
--
作者：
Liu, Qi-Qi;Sun, He-Fen;Jin, Wei
背景根据不同分子亚型评价年轻早期乳腺癌患者放射治疗的意义和获益。方法利用已知激素受体（HoR）和人表皮生长因子受体2 （HER2）状态的监测、流行病学和最终结果数据库进行回顾性队列研究。2010 - 2013年间，年龄18-45岁，接受RT治疗，诊断为T1-3期、N0-3期、M0期原发性乳腺癌的女性患者。结果在23 148例纳入的患者中，分别有14 708例（63.54%）、3385例（14.62%）、1225例（5.29%）和3830例（16.55%）诊断为luminal-A （HoR + HER2-）、luminal-B （HoR + HER2+）、HER2富集（HoR-HER2+）和三阴性（HoR-HER2-）乳腺癌。RT与her2富集患者的总生存率（OS, HR: 0.295; 95% CI:0.138-0.63, P = 0.002）和乳腺癌特异性生存率（BCSS, HR: 0.328; 95% CI: 0.153-0.702, P = 0.004）显著相关。此外，与未接受RT治疗的乳腺癌患者相比，给予luminal-A （HR: 0.696; 95% CI: 0.538-0.902, P = 0.006）和luminal-B (HR: 0.385; 95% CI:0.199-0.744, P = 0.005) RT治疗的乳腺癌患者的OS也明显延长。多变量调整分析显示，HER2是乳腺癌患者RT治疗获益的显著有利因素。结论放疗可显著提高luminal-A、luminal-B，尤其是her2富集的年轻早期乳腺癌女性患者的生存期。这些结果使临床医生能够预测放疗的益处，并改善乳腺癌患者的循证治疗。
Background To evaluate the significance and benefit of radiotherapy (RT) in young early-stage breast cancer patients according to different molecular subtypes. Methods We conducted a retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results database with known hormone receptor (HoR) and human epidermal growth factor receptor 2 (HER2) status. Female patients aged 18-45, received RT treatment, and diagnosed with stage T1-3, N0-3, M0 primary breast cancer between 2010 and 2013 were identified. Results Of all the 23 148 included patients, 14 708 (63.54%), 3385 (14.62%), 1225 (5.29%), and 3830 (16.55%) were diagnosed with luminal-A (HoR + HER2-), luminal-B (HoR + HER2+), HER2-enriched (HoR-HER2+), and triple-negative (HoR-HER2-) breast cancer, respectively. RT was significantly correlated with improved overall survival (OS, HR: 0.295; 95% CI:0.138-0.63, P = 0.002) and breast cancer-specific survival (BCSS, HR: 0.328; 95% CI: 0.153-0.702, P = 0.004) in HER2-enriched patients. In addition, a significantly prolonged OS was also observed when RT was given to luminal-A (HR: 0.696; 95% CI: 0.538-0.902, P = 0.006) and luminal-B (HR: 0.385; 95% CI:0.199-0.744, P = 0.005) breast cancer patients compared to those without RT. Multivariable-adjusted analyses showed that HER2 was a significant favorable factor for RT benefit in breast cancer patients. Conclusions RT could offer significant survival benefit in luminal-A, luminal-B, and especially HER2-enriched young early-stage breast cancer female patients. The results enabled clinicians to predict the benefits of RT and improve evidence-based treatment for breast cancer patients.