Association between adjuvant radiation treatment and breast cancer-specific mortality among older women with comorbidity burden: A comparative effectiveness analysis of SEER-MHOS.
Association between adjuvant radiation treatment and breast cancer-specific mortality among older women with comorbidity burden: A comparative effectiveness analysis of SEER-MHOS.
复制标题
有合并症负担的老年女性辅助放射治疗与乳腺癌特异性死亡率之间的关联：SEER-MHOS 的比较有效性分析。
作者：
国家综合癌症网络建议，患有低风险乳腺癌（LRBC;即，早期、淋巴结阴性和雌激素受体阳性），如果接受激素治疗，则可以省略保乳手术（BCS）后的辅助放射治疗（RT）。然而，RT遗漏和乳腺癌特异性死亡率之间的关系在老年女性合并症中尚不完全清楚。从监测，流行病学和最终结果-医疗保险健康结局调查数据资源中查询了1998-2012年患有LRBC的1105名老年女性（≥65岁），并随访至2018年7月。进行潜在类别分析以确定合并症负担类别。将基于倾向评分的治疗加权逆概率（IPTW）应用于考克斯回归模型，以获得癌症特异性死亡率的子分布风险比（HR）和95% CI，将其他死亡原因作为竞争风险，总体和单独按合并疾病负担分类。确定了三个合并症负担（低、中和高）组。共发生318例死亡（47例与癌症相关）。IPTW校正的考克斯回归分析显示，无论合并症负担如何，RT遗漏与短期、5年和10年癌症特异性死亡无关（分别为p = 0.202和p = 0.536）。然而，RT遗漏可能会增加低合并症负担女性的长期癌症特异性死亡风险（HR = 1.98，95% CI = 1.17，3.33），这需要进一步研究。BCS后省略RT与癌症特异性死亡风险增加无关，被认为是中度至高度合并症负担的老年女性的合理治疗选择。
The National Comprehensive Cancer Network suggested that older women with low‐risk breast cancer (LRBC; i.e., early‐stage, node‐negative, and estrogen receptor‐positive) could omit adjuvant radiation treatment (RT) after breast‐conserving surgery (BCS) if they were treated with hormone therapy. However, the association between RT omission and breast cancer‐specific mortality among older women with comorbidity is not fully known. 1105 older women (≥65 years) with LRBC in 1998–2012 were queried from the Surveillance, Epidemiology, and End Results–Medicare Health Outcomes Survey data resource and were followed up through July 2018. Latent class analysis was performed to identify comorbidity burden classes. A propensity score‐based inverse probability of treatment weighting (IPTW) was applied to Cox regression models to obtain subdistribution hazard ratios (HRs) and 95% CI for cancer‐specific mortality considering other causes of death as competing risks, overall and separately by comorbidity burden class. Three comorbidity burden (low, moderate, and high) groups were identified. A total of 318 deaths (47 cancer‐related) occurred. The IPTW‐adjusted Cox regression analysis showed that RT omission was not associated with short‐term, 5‐ and 10‐year cancer‐specific death (p = 0.202 and p = 0.536, respectively), regardless of comorbidity burden. However, RT omission could increase the risk of long‐term cancer‐specific death in women with low comorbidity burden (HR = 1.98, 95% CI = 1.17, 3.33), which warrants further study. Omission of RT after BCS is not associated with an increased risk of cancer‐specific death and is deemed a reasonable treatment option for older women with moderate to high comorbidity burden.
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影响因子：
3.7
作者：
Downs-Canner, Stephanie;Zabor, Emily C.;Heerdt, Alexandra
通讯作者：
Heerdt, Alexandra
影响因子：
3.8
作者：
Bergen ES;Tichy C;Berghoff AS;Rudas M;Dubsky P;Bago-Horvath Z;Mader RM;Exner R;Gnant M;Zielinski CC;Steger GG;Preusser M;Bartsch R
通讯作者：
Bartsch R
DOI：
10.1177/11782234221145440
发表时间：
2023
期刊：
Breast cancer : basic and clinical research
影响因子：
--
作者：
通讯作者：
--
影响因子：
6.3
作者：
Kent, Erin E.;Malinoff, Rochelle;DeMichele, Kimberly
通讯作者：
DeMichele, Kimberly
影响因子：
45.3
作者：
Arvold, Nils D.;Taghian, Alphonse G.;Harris, Jay R.
通讯作者：
Harris, Jay R.