早期（T1-2N1）三阴型乳腺癌根治术后辅助放疗的疗效评估

目的：评估乳腺癌根治术后放疗（ｐｏｓｔ ｍａｓｔｅｃｔｏｍｙｒａｄｉａｔｉｏｎｔｈｅｒａｐｙ，ＰＭＲＴ）在早期（Ｔ１ ２Ｎ１）三阴型乳腺癌 （ｔｒｉｐｌｅｎｅｇａｔｉｖｅｂｒｅａｓｔｃａｎｃｅｒ，ＴＮＢＣ）患者中的治疗价值。方法：回顾性分析 ＳＥＥＲ数据库中根治术后早期（ｐＴ１ ２Ｎ１） ＴＮＢＣ患者的临床数据。将患者分为根治术后放疗（ＰＭＲＴ）组和无放疗（ｎｏｎ ＰＭＲＴ）组。平衡两组患者的基线特 征，比较两组患者的总生存时间（ｏｖｅｒａｌｌｓｕｒｖｉｖａｌ，ＯＳ）和乳腺癌特异性生存时间（ｂｒｅａｓｔｃａｎｃｅｒ ｓｐｅｃｉｆｉｃｓｕｒｖｉｖａｌ，ＢＣＳＳ）。 通过单多因素 Ｃｏｘ分析确定早期 ＴＮＢＣ患者的预后因素。进行亚组分析，筛选出 ＰＭＲＴ的获益人群。结果：患者的 中位随访时间为 ５１个月。ＰＭＲＴ组及 ｎｏｎ ＰＭＲＴ组 ５年总生存率分别为 ７６．１７％和 ７２．９６％（Ｐ＝０．２６６），５年 ＢＣＳＳ 分别为 ７９．６７％和 ７６．９２％ （Ｐ＝０．２４９），ＰＭＲＴ并不能改善早期 ＴＮＢＣ患者的 ＯＳ（Ｐ＝０．０９５）及 ＢＣＳＳ（Ｐ＝０．１０２）。 亚组分析发现，ＰＭＲＴ仅可改善 Ｔ２Ｎ１期患者的 ＯＳ（Ｐ＝０．００５）及 ＢＣＳＳ（Ｐ＝０．０２１），ＰＭＲＴ组 ５年总生存率为 ７５１８％，ｎｏｎ ＰＭＲＴ组为 ６５．２８％（Ｐ＝０．０３２），５年 ＢＣＳＳ分别为 ７７．３９％和 ６７．４５％（Ｐ＝０．０４０）。结论：在早期 ＴＮ ＢＣ患者中，对 Ｔ２Ｎ１期患者可予以辅助 ＰＭＲＴ以提高生存，对 Ｔ１Ｎ１期患者则不建议进行辅助 ＰＭＲＴ。

Evaluation of the Curative Effects of Post-Mastectomy Radiotherapy for Early(T1-2N1)Triple Negative Breast Cancer

Objective:To evaluate the therapeutic value of post-mastectomy radiotherapy(PMRT)in patients with early(pT1-2N1)triple-negative breast cancer(TNBC).Methods:The clinical data of early TNBC patients after mastectomy in the SEER database were retrospectively analyzed.Patients were assigned to the PMRT group and the non-PMRT group.After propensity score matching,overall survival(OS)and breast cancer-specific survival(BCSS)were compared between the two groups.Univariate and multivariate Cox analyses were used to determine the prognostic factors of early TNBC patients.Subgroup analysis was further carried out to screen out the benefited population of PMRT.Results:The median follow-up time was 51 months.The 5-year OS rates were 76.17% and 72.96%(P=0.266)in the PMRT group and the non-PMRT group,and the 5-year BCSS rates were 79.67% and 76.92%(P=0.249).PMRT did not improve OS(P=0.095)and BCSS(P=0.102)in early TNBC patients.In subgroup analysis,it was found that PMRT only improved OS(P=0.005)and BCSS(P=0.021)in T2N1 patients.The 5-year OS rate was 75.18% in the PMRT group,and 65.28% in the non-PMRT group(P=0.032);and the 5-year BCSS rates were 77.39% and 67.45%(P=0.040).Conclusion:In patients with early(T1-2N1)TNBC,PMRT is recommended for T2N1 patients,which can improve survival.PMRT is not recommended for T1N1 patients.