| Zhang Feng,Zhang Zhuo,Zou Lijuan,Xuan Wei.Analysis of the prognostic factors and the value of radiotherapy in the early stage triple-negative breast cancer[J].Chinese Journal of Radiological Medicine and Protection,2018,38(7):510-516 |
| Analysis of the prognostic factors and the value of radiotherapy in the early stage triple-negative breast cancer |
| Received:October 23, 2017 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.07.006 |
| KeyWords:Triple-negative breast cancer Postoperative radiotherapy Prognosis |
| FundProject:国家自然科学基金（11705095） |
| Author Name | Affiliation | E-mail | | Zhang Feng | Department of Radiotherapy, Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China | | | Zhang Zhuo | Department of Radiotherapy, Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China | 799832582@qq.com | | Zou Lijuan | Department of Radiotherapy, Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China | | | Xuan Wei | Department of Radiotherapy, Shuyang People's Hospital, Shuyan 223600, China | |
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| Abstract:: |
| Objective To analyze the prognostic factors and the value of radiotherapy (RT) for the early stage (T1-2N1M0) triple-negative breast cancer (TNBC) patients after modified radical mastectomy, and provide a basis for the selection of the clinical treatment strategy. Methods The retrospective analysis was performed in 87 TNBC patients at T1-2N1M0 stage. All patients were admitted to the Second Affiliated Hospital of Dalian Medical University from Jan 2006 to Oct 2011. Fifty-three cases received postoperative RT (RT group), and the other 34 cases without RT (non-RT group). Factors enrolled in Kaplan-Meier analysis were postoperative RT, age, menstruation, histological grade, vascular tumor thrombus, T staging, the number of positive lymph node and metastasis rate, surgery procedure, Ki-67 index. The endpoints were local regional recurrence rate (LRR), distant metastasis rate (DM), recurrence free survival (RFS), and overall survival (OS) rate for 5 years. Results The significant difference was found in the 5-year LRR (9.4% vs. 15.2%) and RFS (81.3% vs. 66.7%) between RT group and non-RT group (χ2=8.073, 12.789, P<0.05). No significant difference in the DM and OS was observed between the two groups (P>0.05). The univariate analysis showed that RT, lymph node metastasis, age, and Ki-67 index were the risk factors for 5-year LRR (P<0.05), while vascular thrombus and lymph node metastasis rate were risk factors for 5-year DM (P<0.05), RT, vascular tumor thrombus, lymph node metastasis rate, and Ki-67 index 5-year RFS (P<0.05). The multivariate analysis showed that RT and lymph node metastasis were the independent risk factors for 5-year LRR (HR=0.279, 5.277, P<0.05), vascular thrombus was an independent risk factor 5-year DM (HR=2.313, P<0.05), while RT, vascular tumor thrombus and lymph node metastasis rate were the independent risk factors for 5 years RFS (HR=0.378, 2.350, 5.084, P<0.05). Conclusions Postoperative RT might improve the local control rate of TNBC patients at T1-2N1M0 stage, while the effect on DM and OS in 5 years was little. Postoperative RT, lymph node metastasis rate, vascular tumor thrombus, Ki-67 index and age are related to patient's prognosis of early stage TNBC. |
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