在光线A乳腺癌的乳腺保护手术后不进行放射治疗
Timothy J Whelan1, Sally Smith1, Sameer Parpia1
1From the Department of Oncology, McMaster University and the Division of Radiation Oncology, Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, ON (T.J.W., I.S.D., J.R.W.), the Division of Radiation Oncology, Department of Surgery, University of British Columbia and Radiation Therapy Program, BC Cancer Agency, Victoria (S.S.), the Department of Oncology, McMaster University, Hamilton, ON (S. Parpia, G.P., M.N.L.), the Department of Radiation Oncology, University of Toronto, and the Radiation Medicine Program, Princess Margaret Cancer Centre (A.W.F., F.-F.L.), the Department of Pathology, University of Toronto (A.B.), and the Department of Radiation Oncology, University of Toronto and Sunnybrook Odette Cancer Centre (E.R.), Toronto, the Department of Radiation Oncology, University of Ottawa and Ottawa Regional Cancer Centre, Ottawa (L.C.), the Department of Radiation Oncology, University of Toronto and Royal Victoria Regional Health Centre, Barrie, ON (C.S.), the Department of Radiation Oncology, Laurentian University and Radiation Treatment Program, Northeast Cancer Centre, Health Sciences North, Sudbury, ON (J.B.), the Department of Radiation Oncology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC (S. Provencher), the Department of Radiation Oncology, Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, QC (V.T.), the Department of Laboratory Medicine and Pathobiology, and the Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto (A.M.M.), the Department of Pathology and Laboratory Medicine, University of British Columbia, and the BC Cancer Agency, Vancouver (Z.K.), the Department of Radiation Oncology, University of Manitoba and Cancer Care Manitoba, Winnipeg (M.A.A.), the Department of Radiation Oncology, University of British Columbia and Radiation Therapy Program, BC Cancer Agency, Vancouver (K.D.V.), the Department of Radiation Oncology, McGill University, Montreal (T.H.), and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver (T.O.N.) - all in Canada.
对于经过手术后的早期发光性A乳腺癌患者55岁以上,省略放射治疗是安全的. 在没有放射治疗的5年内,局部复发率仍然很低,这表明一种可行的治疗选择.
科学领域:
- 在瘤学瘤学.
- 辐射疗法 辐射疗法
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 在乳腺保护手术后,辅助放射治疗是标准的,以降低局部复发风险.
- 放射治疗带来不便,成本和潜在的副作用.
- 仅仅临床病理因素不足以识别那些可能避免放射治疗的低风险患者.
研究的目的:
- 评估在选择早期,光线A乳腺癌患者中省略辅助放射治疗的安全性和有效性.
- 为了确定在这个患者群体中,是否可以在不进行放射治疗的情况下实现低的5年局部复发率 (<5%).
主要方法:
- 一项前性队列研究招募了500名女性 (≥55岁),她们患有T1N0,1-2级,光线A乳腺癌,经过乳腺保护手术和内分泌治疗.
- 低Ki67指数 (≤13.25%) 的患者被录取,并没有接受放射治疗.
- 主要终点是乳房侧面乳房的局部复发,预先定义了可接受的5年累积发病率上限.
主要成果:
- 5年后,局部复发率为2.3% (90% CI,1.3-3.8%),达到预先规定的可接受风险值.
- 逆侧乳腺癌发生在1.9%的患者中.
- 在2.7%的患者中观察到任何类型的整体复发.
结论:
- 在55岁以上的T1N0,1级1-2,光线A乳腺癌患者中,放弃放射治疗,以乳腺保护手术和内分泌疗法治疗,导致5年局部复发发病率较低.
- 这种方法表明,在精选的早期乳腺癌患者中,有可能安全地避免放射治疗.
更多相关视频
13:43Intraductal Delivery and X-ray Visualization of Ethanol-Based Ablative Solution for Prevention and Local Treatment of Breast Cancer in Mouse Models
Published on: April 1, 2022
12:57X-Ray Visualization of Intraductal Ethanol-Based Ablative Treatment for Prevention of Breast Cancer in Rat Models
Published on: December 9, 2022
