Efficacy of postmastectomy radiotherapy for HER2-positive T 1-2N 1M 0 breast cancer
10.3760/cma.j.cn112271-20230508-00136
- VernacularTitle:HER2阳性T 1~2N 1M 0乳腺癌改良根治术后放疗疗效的影响因素分析
- Author:
Yongchun ZHOU
1
;
Yaoguo YANG
;
Nan SUN
;
Lingxiao XIE
;
Xianglu SUN
;
Aoxue LI
;
Qiong WU
;
Lei ZHANG
;
Hao JIANG
Author Information
1. 蚌埠医学院第一附属医院肿瘤放疗科，蚌埠 233000
- Keywords:
Breast cancer;
Human epidermal growth factor receptor 2 (HER2) positive;
Anti HER2 targeted therapy;
Postmastectomy radiotherapy (PMRT)
- From:
Chinese Journal of Radiological Medicine and Protection
2023;43(9):676-681
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of postmastectomy radiotherapy (PMRT) for human epidermal growth factor receptor 2 (HER2)-positive T 1-2N 1M 0 breast cancer in the context of HER2-targeted therapy. Methods:This study collected the clinical data of 105 female patients with HER2-positive T 1-2N 1M 0 breast cancer who underwent modified radical mastectomy in the First Affiliated Hospital of Bengbu Medical College from January 2013 to December 2019. Then, the clinical outcomes of these patients were observed, and the prognostic factors and the efficacy of PMRT were analyzed. Results:The median follow-up time was 50 months (ranging from 14 to 107 months), and the 5-year overall survival (OS), local-regional recurrence-free survival(LRFS), and disease-free survival (DFS) were 81.6%, 91.9%, and 76.2%, respectively. The multivariate analysis indicated that independent prognostic factors for OS and DFS include the age, pathologic grade, and tumor size; the independent risk factors for LRFS include positive lymph node ratio (LNR) and hormone receptor (HR) status; and the independent prognostic factor for DFS was PMRT (HR: 2.85, 95% CI: 1.10-8.80, P < 0.05). The subgroup analysis suggested that PMRT significantly improved the OS of various high-risk subgroups ( χ2=4.01-9.18, P < 0.05). However, the further stratified analysis indicated that PMRT only increased the OS of the patients who did not receive HER2-targeted therapy in various high-risk subgroups ( χ2=4.50-6.70, P < 0.05), while there was no statistical difference before and after PMRT for the individuals who received targeted treatment ( P > 0.05). Conclusions:PMRT is an independent prognostic factor for the DFS of patients with HER2-positive T 1-2N 1M 0 breast cancer who underwent modified radical mastectomy. PMRT can improve the OS of high-risk patients with ages < 45 years old, pathologic grade Ⅲ, tumor diameter ≥ 3 cm, LNR > 10%, and HR (-) who received no HER2-targeted therapy. However, the efficacy may be compromised to some extent in the context of the application of HER2-targeted therapy.
