Evolving treatment strategies for inflammatory breast cancer: A population-based survival analysis
Evolving treatment strategies for inflammatory breast cancer: A population-based survival analysis
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DOI：
10.1200/jco.2005.06.233
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发表时间：
2005-03-20
影响因子：
45.3
通讯作者：
Truong, PT
中科院分区：
文献类型：
--
作者：
Panades, M;Olivotto, IA;Truong, PT
目的探讨乳腺切除术（Mx）的应用、化疗（CT）强度、CT、放疗（RT）的治疗顺序，患者和方法回顾性分析了1980年至2000年间在不列颠哥伦比亚省诊断的485例IBC患者，分析了局部无复发生存率（LRFS）和乳腺癌特异性生存率（BCSS）。治疗意图和接受的治疗。治愈的意图被定义为超过四个周期的蒽环类药物为基础的CT加局部RT在患者无远处metastasis. ResultsMedian随访生存者为6.5年。诊断时有远处转移的患者或接受治愈性治疗的患者的中位BCSS分别为1.0年和3.2年。在治愈性治疗的患者中（n = 308），LRFS或BCSS与CT/RT之前或之后的Mx时间、诊断与RT之间的时间或RT与CT的顺序无显著差异。与标准CT相比，接受强化CT的患者10年BCSS改善（43.7% vs 26.3%; P = 0.04）。CT后有Mx、CT前有Mx和无Mx患者的10年LRFS分别为62.8%、58.6%和34.4%（P = .0001）;相应的10年BCSS分别为36.9%、19.9%和22.5%（P = .005）。在多变量分析中，Mx与LRFS改善相关（P = 0.04）。BCSS的独立预后因素是绝经状态（P = .02）、雌激素受体状态（P = .02）和CT类型（P = .05）。结论乳腺切除术联合CT和RT似乎能提高局部控制，而现代CT方案似乎能改善BCSS。(c)2005年，美国临床肿瘤学会。
Purpose To determine if mastectomy (Mx) use, chemotherapy (CT) intensity, or treatment sequence of CT, radiation therapy (RT), and Mx have improved outcome for inflammatory breast cancer (IBC).Patients and Methods A retrospective analysis of 485 patients with IBC diagnosed in British Columbia between 1980 and 2000 analyzed locoregional relapse-free survival (LRFS) and breast cancer-specific survival (BCSS) by treatment intent and treatment received. Curative intent was defined as delivery of more than four cycles of anthracycline-based CT plus locoregional RT in patients without distant metastases.Results Median follow-up among survivors was 6.5 years. Median BCSS was 1.0 and 3.2 years for patients with distant metastases at diagnosis or those who were curatively treated, respectively. Among patients treated curatively (n = 308), there were no significant differences in LRFS or BCSS with timing of Mx before or after CT/RT, time between diagnosis and RT, or the sequence of RT and CT. Patients receiving more intensive CT had improved 10-year BCSS compared with standard CT (43.7% v 26.3%; P = .04). Ten-year LRFS for patients having Mx after CT, Mx before CT, and without Mx was 62.8%, 58.6%, and 34.4%, respectively (P = .0001); the corresponding 10-year BCSS was 36.9%, 19.9%, and 22.5%, respectively (P = .005). On multivariate analysis, Mx was associated with improved LRFS (P = .04). Independent prognostic factors for BCSS were menopausal status (P = .02), estrogen receptor status (P = .02), and CT type (P = .05).Conclusion This retrospective analysis suggested that mastectomy, in conjunction with CT and RT, seemed to enhance locoregional control, whereas modern CT regimens seemed to improve BCSS. (c) 2005 by American Society of Clinical Oncology.