在对新辅助化疗反应后省略区域节点辐射
Eleftherios P Mamounas1, Hanna Bandos2,3, Julia R White4
1AdventHealth Cancer Institute, Orlando, FL.
The New England journal of medicine
|June 4, 2025
概括
区域节点辐射没有改善乳腺癌患者的结果,这些患者在化疗后获得了节点阴性状态. 这项研究发现,在添加这种放射治疗时,无复发性存活率或整体存活率没有显著的益处.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 区域节点辐射 (RNI) 的疗效已在节点阳性乳腺癌患者中得到证实.
- 它对患有病理结节阴性 (ypN0) 状态的患者在新辅助化疗后的益处是不确定的.
研究的目的:
- 为了确定RNI是否会改善乳腺癌患者在新辅助化疗后的ypN0状态的结果.
- 评估RNI对侵袭性乳腺癌无复发间隔和存活率的影响.
主要方法:
- 一个随机试验比较RNI与没有RNI在经过活检验证的,结节阳性乳腺癌患者达到ypN0状态.
- 主要终点:侵袭性乳腺癌无复发间隔. 二级终点:局部区域无复发间隔,远程无复发间隔,无病生存率,总生存率和安全性.
主要成果:
- 在1641名患者 (1556名初级分析中),RNI没有显著改善侵袭性乳腺癌无复发间隔 (HR 0.88,P=0.51).
- 没有观察到局部区域无复发间隔,远程无复发间隔,无病存活率或组间整体存活率的显著差异.
- 治疗耐受性良好,没有意外的不良事件;4级不良事件很少发生.
结论:
- 辅助性RNI不会降低乳腺癌复发或死亡的风险 ypN0 状态的乳腺癌患者后的neoadjuvant化疗.
- 这些发现表明,RNI可能对这个特定的患者亚组没有好处.
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