P53 STATUS PREDICTS SURVIVAL IN BREAST-CANCER PATIENTS TREATED WITH OR WITHOUT POSTOPERATIVE RADIOTHERAPY - A NOVEL HYPOTHESIS BASED ON CLINICAL FINDINGS
P53 STATUS PREDICTS SURVIVAL IN BREAST-CANCER PATIENTS TREATED WITH OR WITHOUT POSTOPERATIVE RADIOTHERAPY - A NOVEL HYPOTHESIS BASED ON CLINICAL FINDINGS
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DOI：
10.1200/jco.1995.13.11.2745
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发表时间：
1995-11-01
影响因子：
45.3
通讯作者：
BERGH, J
中科院分区：
文献类型：
--
作者：
JANSSON, T;INGANAS, M;BERGH, J
目的和方法：使用基于cDNA的测序方法，研究了206例连续患者中无腋窝转移的原发性乳腺癌肿瘤中是否存在完整的p53基因。临床随访数据和结果的淋巴结阴性患者没有任何辅助全身治疗（n = 168）相关的局部放疗和p53 status.Results：p53突变发生在31淋巴结阴性乳腺癌患者谁没有接受任何系统的辅助治疗，但术后局部放疗或没有。接受局部区域放疗治疗时，伴有p53突变的淋巴结阴性乳腺癌患者的无复发生存率（P = .0007）、乳腺癌校正生存率（P = .01）和总生存率（P = .02）显着提高。在携带野生型p53的淋巴结阴性乳腺癌患者中，接受局部区域放射治疗的患者与未接受局部区域放射治疗的患者的结局无统计学显著差异。考克斯比例风险模型表明，突变型p53与放疗疗效无关，且突变型p53与野生型p53的放疗疗效有质的差异。结论：我们的临床结果确定了一组局部放疗可提高无复发、乳腺癌纠正和总生存率的乳腺癌患者。对p53突变的放射治疗淋巴结阴性乳腺癌患者的结果表明，即使存在p53突变，放射治疗也能诱导细胞死亡。(C)1995年，美国临床肿瘤学会。
Purpose and Methods: Primary breast cancer tumors without axillary metastases from 206 consecutive patients in a population-based cohort were investigated with regard to the presence of an intact p53 gene using a cDNA based sequencing method. Clinical follow-up data and outcome of node-negative patients without any adjuvant systemic therapy (n = 168)were related to locoregional radiotherapy and p53 status.Results: Mutations in p53 occurred in 31 node-negative breast cancer patients who did not receive any systemic adjuvant treatment, but were treated with postoperative locoregional radiotherapy or nothing. Node-negative breast cancer patients with p53 mutations had significantly improved relapse-free survival (P = .0007), breast cancer corrected survival (P = .01), and overall survival (P = .02) rates when treated with locoregional radiotherapy. In node-negative breast cancer patients with wild-type p53, there was no statistically significant difference in outcome between patients who received lo coregional radiotherapy and those who did not. Cox proportional hazards models indicate that mutant p53 is associated with worse prognosis independent of response to radiotherapy and that response to radiotherapy is qualitatively different in tumors with p53 mutations compared with those with wild-type p53.Conclusion: Our clinical findings define a group of breast cancer patients in whom locoregional radiotherapy improves relapse-free, breast cancer-corrected, and overall survival. The outcome for irradiated node-negative breast cancer patients with p53 alterations indicates that irradiation can induce cell death even in the presence of p53 mutations.(C) 1995 by American Society of Clinical Oncology.