Efficacy of post‑mastectomy radiotherapy in patients with T1‑2N1 breast cancer aged ≤35 years or with a positive HER‑2 status.

IF 1.4 Q4 ONCOLOGY Molecular and clinical oncology Pub Date : 2023-07-01 DOI:10.3892/mco.2023.2654
Mincong Wang, Yali Wang, Fei Xie, Hongtao Ren, Jing Chen, Zhongwei Wang
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Abstract

Post-mastectomy radiotherapy (PMRT) is highly recommended for patients with breast cancer with one to three positive nodes; however, there remains some controversy regarding its use. The present retrospective study aimed to explore which patients may be able to avoid PMRT and its associated side effects. A total of 728 patients with T1-2N1 breast cancer who were treated with or without PMRT were included in the present study. The results suggested that PMRT significantly decreased the locoregional recurrence rate (LRR) [hazard ratio (HR)=5.602, 95% confidence interval (CI)=3.139-9.998, P<0.01; 3-year LRR: 4 vs. 17%] and improved overall survival (OS) (HR=0.651, 95% CI=0.437-0.971, P=0.03; 3-year OS: 91 vs. 87%) for patients with T1-2N1 breast cancer. By contrast, PMRT had no significant effect on the distant metastasis (DM) rate (HR=0.691, 95% CI=0.468-1.019, P=0.06; 3-year DM: 10 vs. 15%). Further stratified analysis revealed that PMRT did not reduce the LRR and DM, or improve OS in patients aged ≤35 years or in those with a positive human epidermal growth factor receptor-2 (HER-2) status. The analysis of 438 patients treated with PMRT revealed that patients aged ≤35 years or those with a positive HER-2 status were more likely to experience local recurrence even following PMRT. Thus, the benefits of using PMRT in patients with T1-2N1 breast cancer who are aged ≤35 years or in those with a positive HER-2 status need to be carefully considered. Further studies are required to confirm whether this patient group may be exempted from PMRT.

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年龄≤35岁或HER - 2阳性T1 - 2N1乳腺癌患者乳房切除术后放疗的疗效
对于有一至三个阳性淋巴结的乳腺癌患者,强烈推荐乳房切除术后放疗(PMRT);然而,关于它的使用仍然存在一些争议。本回顾性研究旨在探讨哪些患者可以避免PMRT及其相关副作用。本研究共纳入728例接受或不接受PMRT治疗的T1-2N1乳腺癌患者。结果显示,PMRT可显著降低局部复发率(LRR)[危险比(HR)=5.602, 95%可信区间(CI)=3.139 ~ 9.998, P
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108
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