ObjectiveTo investigate the prognostic role of radiotherapy in women aged 70 years or older with breast cancer. MethodsA total of 311 women aged 70 years or older with breast cancer undergoing breast-conserving surgery in the Second Affiliated Hospital of Nanchang University between February 28， 2011 and February 28， 2021， were divided into two groups： 183 patients in the control group were given postoperative radiotherapy， and 128 patients in the case group were not treated by radiotherapy. The nonparametric Mann-Whitney U test or χ² test was used to compare the general clinicopathological data of the two groups， the Kaplan-Meier method and log-rank test to analyze the disease-free survival （DFS） and overall survival （OS）， multivariate Cox proportional hazards regression model to examine the factors affecting DFS and OS. Additional subgroup analysis was performed. ResultsThere were no statistically significant differences between the control and case groups in age， T-stage， N-stage， tumor clinical stage， estrogen receptor （ER）， progesterone receptor （PR） and human epidermal growth factor receptor type 2 （HER2） statuses， Ki-67， tumor histological grade， tumor pathological type， and whether they received adjuvant chemotherapy or postoperative endocrine therapy （all P > 0.05）. The median follow-up was 110.0 （95%CI： 98.9， 121.1） months for the control group and 93.0 （95% CI： 86.1， 100.0） months for the case group. Differences between the two groups in DFS rate were significant （92.9% vs. 85.2%， P = 0.024）， but in OS rate insignificant （92.3% vs. 88.3%， P=0.199）. Multivariate Cox proportional hazards regression analysis showed that T-stage， N-stage （N2 and N3）， HER2 status， Ki-67， tumor histological grade （grade Ⅱ and Ⅲ）， and no radiotherapy were independent risk factors for DFS in elderly breast cancer patients （all P < 0.05）， while ER status was an independent protective factor （P < 0.05）. The independent risk factors for OS in elderly breast cancer patients included tumor stage， N-stage （N2 and N3）， HER2 status， and Ki-67 （all P < 0.05）， and ER status was an independent protective factor （P < 0.05）. Subgroup analysis revealed that in elderly hormone receptor （HR）-negative breast cancer patients， the median follow-ups of the control and case groups were 123.0 （95% CI： 116.8， 129.2） months and 88.0 （95% CI： 75.2， 100.8） months， respectively， with a statistically significant difference both in DFS （91.3% vs. 68.6%， P=0.008） and OS rates （89.1% vs. 71.4%， P=0.027）. ConclusionsPost-breast-conserving radiotherapy provides a limited survival benefit in the overall elderly breast cancer patients， but a significant survival benefit in the elderly HR-negative breast cancer patients， which suggests the need for a prospective randomized controlled trial of a stratified step-down strategy for radiotherapy in elderly breast cancer patients.

[Objective] To explore the feasibility of exemption from radiotherapy after breast-conserving surgery for hormone receptor-negative elderly breast cancer. [Methods] A total of 139 estrogen receptor (ER) and progesterone receptor (PR)-negative older adults with breast cancer who underwent breast-conserving surgery admitted to the Second Affiliated Hospital of Nanchang University from December 1, 2013 to December 1, 2018 were recruited as the subjects of the study, and were divided into a case group of 67 patients who did not undergo postoperative radiotherapy and a control group of 72 ones who underwent postoperative radiotherapy, according to whether they received postoperative radiotherapy or not. Clinicopathological data including age, tumor T stage, tumor N stage, tumor Nottingham grade, pathology type, human epidermal growth factor receptor 2 (HER2) expression status, and chemotherapy regimen were collected and compared between the two groups. The study analyzed the 5-year disease-free survival (DFS) and 5-year overall survival (OS) of two groups of patients. The log-rank test was used to compare the survival rate, and a multifactorial COX proportional hazards regression model was used to analyze the effect of exempted radiotherapy after breast-conserving surgery on DFS and OS of hormone receptor-negative elderly breast cancer mammary carcinoma. [Results] The two groups did not significantly differ in age, tumor T-stage, tumor N-stage, pathological type, tumor Nottingham grade, HER2 status, or chemotherapeutic regimen (all P>0.05). The 5-year DFS rate of 139 hormone receptor-negative elderly breast cancer cases was 74.1% and the 5-year OS rate was 83.5%. The difference in the 5-year DSF rate between the case group and the control group was statistically significant (65.7 vs. 81.9%, P=0.023), but the difference in the 5-year OS rate was not statistically significant (79.1% vs. 87.5%, P=0.186). The results of multifactorial COX proportional risk regression model analysis showed that exemption from radiotherapy after breast-conserving surgery was an independent risk factor for DFS (HR=2.298, 95% CI: 1.113-4.746, P=0.024), but not for OS (HR=1.831, 95% CI: 0.740-4.532, P=0.191). [Conclusion] Hormone receptor-negative elderly breast cancer according to exemption of radiotherapy after breast-conserving surgery has a higher local recurrence rate, but OS has no significant effect. Therefore, whether hormone receptor-negative elderly breast cancer can be exempted from radiotherapy after breast-conserving surgery still needs to be verified by further clinical trials.

[Objective]To investigate whether severe myelosuppression after chemotherapy is associated with progno-sis in patients with breast cancer.[Methods]Triple negative breast cancer(TNBC)patients who received chemotherapy at the Second Affiliated Hospital of Nanchang University from May 2,2013 to May 2,2018 were divided into a control group(no/mild myelosuppression)and a case group(severe myelosuppression).In this study,251 patients with TNBC met the inclusion and exclusion criteria,including 125 patients in the control group(20 patients with grade 0 myelosuppression,43 patients with grade I myelosuppression,62 patients with grade Ⅱ myelosuppression),126 patients in the case group(114 patients with grade Ⅲ myelosuppression,12 patients with grade Ⅳ myelosuppression).The general clinicopathologi-cal data of the patients in the two groups,including age,pathological type of tumor,tumor T stage,tumor N stage,tumor Nottingham grade,intravascular cancer thrombus,were analyzed using the χ2 test.The disease-free survival(DFS)and overall survival(OS)of the two groups were analyzed using the Kaplan-Meier method.A Cox proportional hazards regres-sion model with multiple factors was used to analyze the impact of post-chemotherapy severe myelosuppression on disease-free survival(DFS)and overall survival(OS)in patients with TNBC.[Results]The differences in general clinicopatholog-ic data between the two groups of patients were not statistically significant(all P＞0.05).The 5-year disease-free survival(DFS)rate was significantly lower in the control group compared with the case group(75.2%vs.85.7%,P=0.027).How-ever,there was no statistically significant difference in the 5-year overall survival(OS)rate between the two groups(88.8%vs.95.2%,P=0.057).The analysis of the multifactorial Cox proportional hazards regression model revealed that post-chemotherapy severe myelosuppression was an independent protective factor for disease-free survival(DFS)(HR=0.332,95%CI:0.173-0.638,P=0.001)and overall survival(OS)(HR=0.193,95%CI:0.062-0.602,P=0.005)in TN-BC patients.[Conclusion]Our results show that TNBC patients with severe myelosuppression after chemotherapy have lon-ger disease-free survival(DFS)than those with no/mild myelosuppression,and overall survival(OS)also tend to be pro-longed compared with those with no/mild myelosuppression,and severe myelosuppression after chemotherapy can be used as an independent predictor of a good prognosis in breast cancer.

Because of the increasing importance of medical equipment in hospital,medical equipment maintenance division,a department guaranteeing the normal performance of medical equipment,will also act as a vital way.This paper introduces some problems in the management of medical equipment maintenance division and analyses the reasons.Some ways and means are suggested to manage the medical equipment maintenance.