Analysis of the prognostic factors and the value of radiotherapy in the early stage triple-negative breast cancer
10.3760/cma.j.issn.0254-5098.2018.07.006
- VernacularTitle: 早期三阴乳腺癌改良根治术后放疗及预后相关因素分析
- Author:
Feng ZHANG
1
;
Zhuo ZHANG
1
;
Lijuan ZOU
1
;
Wei XUAN
2
Author Information
1. Department of Radiotherapy, Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China
2. Department of Radiotherapy, Shuyang People＇s Hospital, Shuyan 223600, China
- Publication Type:Journal Article
- Keywords:
Triple-negative breast cancer;
Postoperative radiotherapy;
Prognosis
- From:
Chinese Journal of Radiological Medicine and Protection
2018;38(7):510-516
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the prognostic factors and the value of radiotherapy (RT) for the early stage (T1-2N1M0) triple-negative breast cancer (TNBC) patients after modified radical mastectomy, and provide a basis for the selection of the clinical treatment strategy.
Methods:The retrospective analysis was performed in 87 TNBC patients at T1-2N1M0 stage. All patients were admitted to the Second Affiliated Hospital of Dalian Medical University from Jan 2006 to Oct 2011. Fifty-three cases received postoperative RT (RT group), and the other 34 cases without RT (non-RT group). Factors enrolled in Kaplan-Meier analysis were postoperative RT, age, menstruation, histological grade, vascular tumor thrombus, T staging, the number of positive lymph node and metastasis rate, surgery procedure, Ki-67 index. The endpoints were local regional recurrence rate (LRR), distant metastasis rate (DM), recurrence free survival (RFS), and overall survival (OS) rate for 5 years.
Results:The significant difference was found in the 5-year LRR (9.4% vs. 15.2%) and RFS (81.3% vs. 66.7%) between RT group and non-RT group (χ2=8.073, 12.789, P<0.05). No significant difference in the DM and OS was observed between the two groups (P>0.05). The univariate analysis showed that RT, lymph node metastasis, age, and Ki-67 index were the risk factors for 5-year LRR (P<0.05), while vascular thrombus and lymph node metastasis rate were risk factors for 5-year DM (P<0.05), RT, vascular tumor thrombus, lymph node metastasis rate, and Ki-67 index 5-year RFS (P<0.05). The multivariate analysis showed that RT and lymph node metastasis were the independent risk factors for 5-year LRR (HR=0.279, 5.277, P<0.05), vascular thrombus was an independent risk factor 5-year DM (HR=2.313, P<0.05), while RT, vascular tumor thrombus and lymph node metastasis rate were the independent risk factors for 5 years RFS (HR=0.378, 2.350, 5.084, P<0.05).
Conclusions:Postoperative RT might improve the local control rate of TNBC patients at T1-2N1M0 stage, while the effect on DM and OS in 5 years was little. Postoperative RT, lymph node metastasis rate, vascular tumor thrombus, Ki-67 index and age are related to patient′s prognosis of early stage TNBC.
