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优化早期乳腺癌的放射治疗:对新辅助,术内和术后方法的基于SEER的比较分析

Lingrui Li¹, Xiangyi Kong¹, Zhuang Xiong²

¹Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Science progress

|January 30, 2026

概括

与术后放射治疗 (PORT) 相比,新辅助放射治疗 (NART) 和手术内放射治疗 (IORT) 不能改善早期乳腺癌患者的长期存活率. NART与较低的整体存活率和第二次原发性恶性瘤风险的降低有关.

科学领域:

在瘤学瘤学.
辐射瘤学辐射瘤学
癌症研究癌症研究

背景情况:

早期乳腺癌的治疗包括各种辐射疗法.
对比不同放射治疗序列的长期结果对于优化患者护理至关重要.

研究的目的:

为了比较长期生存结果 (整体存活率,乳腺癌特异性存活率) 和早期乳腺癌患者治疗新辅助放射治疗 (NART),术内放射治疗 (IORT) 与术后放射治疗 (PORT) 的第二次原发性恶性瘤 (SPM) 的风险.

主要方法:

追溯分析SEER数据库中的数据.
倾向性得分匹配 (1:1) 用于比较NART和PORT组以及IORT和PORT组之间的结果.
分析的关键结局包括整体存活率 (OS),乳腺癌特异性存活率 (BCSS) 和第二原发性恶性瘤 (SPMs).

主要成果:

与PORT相比,NART与20年整体存活率 (OS) 显著降低 (p < 0.01),特别是在激素受体阳性患者中.
在NART和PORT之间没有观察到乳腺癌特异性生存率 (BCSS) 的显著差异.
与PORT相比,接受NART的患者所有SPM (p = 0.01) 和第二种固体癌症 (p = 0.02) 的风险较低,但第二种血液性恶性瘤的风险与PORT相比相似.
在IORT和PORT组之间没有发现OS,BCSS或SPM风险的显著差异.

结论:

新辅助放射治疗 (NART) 和手术内放射治疗 (IORT) 对早期乳腺癌的术后放射治疗 (PORT) 没有生存优势.
放射治疗的使用顺序需要仔细考虑,因为NART可能会影响长期整体存活率.
虽然NART可能会降低某些第二原发性恶性瘤的风险,但它对整体存活率的影响需要进一步研究.

关键词:

新辅助性辐射疗法新辅助性辐射治疗乳腺保护手术是什么?在手术内进行的放射治疗.第二种主要恶性瘤.幸存率幸存率生存率

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