Delay in initiating postmastectomy radiotherapy is associated with inferiorsurvival outcomes for locally advanced breast cancer patients treated with neoadjuvant chemotherapy and mastectomy
10.3760/cma.j.issn.1004-4221.2019.04.007
- VernacularTitle:乳腺癌新辅助化疗后改良根治术后放疗开始时间对预后的影响
- Author:
Zhou HUANG
1
;
Shulian WANG
;
Yu TANG
;
Qinglin RONG
;
Li ZHU
;
Mei SHI
;
Xiaobo HUANG
;
Liangfang SHEN
;
Jing CHENG
;
Jun ZHANG
;
Jiayi CHEN
;
Hongfen WU
;
Min LIU
;
Changying MA
;
Yexiong LI
Author Information
1. 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科 100021
- Keywords:
Breast neoplasm/neoadjuvant chemotherapy;
Breast neoplasm/modified mastectomy;
Breast neoplasm/radiotherapy;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2019;28(4):280-285
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of surgery-radiotherapy interval (SRI) on clinical prognosis of locally advanced stage c Ⅱ-Ⅲ breast cancer patients treated with neoadjuvant chemtherapy and modified radical mastectomy.Methods Clinical data of 1 087 breast cancer patients treated with neoadjuvant chemotherapy and modified radical mastectomy from 11 hospitals in China were retrospectively analyzed.The optimal threshold value of SRI upon clinical prognosis was determined by maxstat method.The effect of SRI on clinical prognosis was evaluated by using multivariate Cox regression analysis and propensity score matching (PSM).Results The median follow-up time was 72.9 months.The 5-year disease-free survival (DFS) and overall survival (OS) rates were 68.1％ and 81.8％.All patients were divided into SRI ≤18 weeks (n=917) and SRI＞ 18 weeks groups (n=170).Multivariate Cox regression analysis demonstrated that hormone receptor status (P＜0.001),pathological T stage (P＜0.001),pathological N stage (P＜0.001) and SRI (P=0.023) were independent influencing factors of DFS.Hormone receptor status (P=0.013),pathological T stage (P=0.006),pathological N stage (P＜0.001),endocrine therapy (P=0.013) and SRI (P=0.001) were significantly associated with OS.After balancing the clinical and pathological factors with PSM,patients with SRI＜ 18 weeks had superior DFS and OS to those with SRI＞ 18 weeks.Conclusions SRI affects the clinical prognosis of locally advanced breast cancer patients treated with neoadjuvant chemotherapy and modified radical mastectomy.Radiotherapy should be performed within 18 weeks after mastectomy.
