RADICAL RADIOTHERAPY ALONE IN NON-OPERABLE BREAST-CANCER - THE MAJOR IMPACT OF TUMOR SIZE AND HISTOLOGICAL GRADE ON PROGNOSIS
RADICAL RADIOTHERAPY ALONE IN NON-OPERABLE BREAST-CANCER - THE MAJOR IMPACT OF TUMOR SIZE AND HISTOLOGICAL GRADE ON PROGNOSIS
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DOI：
10.1016/0167-8140(88)90222-8
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发表时间：
1988-12-01
影响因子：
5.7
通讯作者：
SARRAZIN, D
中科院分区：
文献类型：
--
作者：
THOMAS, F;ARRIAGADA, R;SARRAZIN, D
这项回顾性研究涉及319例不可手术的乳腺癌患者，这些患者在Gustave-Pancresy研究所（IGR）接受了65戈伊剂量的单独放疗。这些患者要么有可手术的肿瘤，但不适合全身麻醉，或有不可手术的肿瘤，由于当地的禁忌症。其中大部分为晚期肿瘤：21% < 7 cm; 30%为N2或N3; 30%为炎性癌。5年和10年生存率分别为40%和19%。局部和远处无复发率分别为56%和33%，5年和44%和28%，10年。根据肿瘤大小、临床淋巴结转移、组织学分级、年龄、皮肤浸润和肿瘤剂量对结果进行分析。多因素分析表明，肿瘤大小（p = 10-3）和组织学分级（HG）（p = 10-2）都是预测局部复发的重要因素。组织学分级（p = 10-3）、肿瘤大小（p = 10-2）和临床淋巴结受累（p = 10-2）是预测远处复发的最重要因素。根据上述因素定义局部复发和远处复发的个体风险（IR），并被证明是良好的预后指标。肿瘤剂量高于80戈伊并不增加局部控制。我们建议普遍使用组织学分级，因为它似乎对预测单纯放疗患者的局部和远处控制很重要。
This retrospective study involved 319 non-operable breast cancer patients treated by radiotherapy alone with doses of 65 Gy at the Institut Gustave-Roussy (IGR). These patients either had operable tumors but were unfit for general anesthesia or had inoperable tumors due to local contraindications. Most of them had advanced tumors: 21% < 7 cm; 30% N2 or N3; 30% with inflammatory carcinomas. The 5- and 10-year survival was 40 and 19%, respectively. The local and distant relapse-free rate was 56 and 33% at 5 years and 44 and 28% at 10 years respectively. Results were analyzed according to tumor size, clinical node involvement, histologic grade, age, skin invasion and tumor dose. A multivariate analysis demonstrated that tumor size (p = 10-3) and histological grade (HG) (p = 10-2) were both significant factors predicting local relapse. Histological grade (p = 10-3), tumor size (p = 10-2) and clinical node involvement (p = 10-2) were the most significant factors predicting distant relapses. An individual risk (IR) of local recurrence and of distant recurrence was defined according to the above factors and was demonstrated to be good prognostic index. Tumor doses above 80 Gy did not increase local control. We recommend the general use of histological grading as it seems important for prediction of local and distant control in patients treated by radiotherapy alone.