| Zhou Yongchun,Yang Yaoguo,Sun Nan,Xie Lingxiao,Sun Xianglu,Li Aoxue,Wu Qiong,Zhang Lei,Jiang Hao.Efficacy of postmastectomy radiotherapy for HER2-positive T1-2N1M0 breast cancer[J].Chinese Journal of Radiological Medicine and Protection,2023,43(9):676-681 |
| Efficacy of postmastectomy radiotherapy for HER2-positive T1-2N1M0 breast cancer |
| Received:May 08, 2023 |
| DOI：10.3760/cma.j.cn112271-20230508-00136 |
| KeyWords:Breast cancer Human epidermal growth factor receptor 2 (HER2) positive Anti HER2 targeted therapy Postmastectomy radiotherapy (PMRT) |
| FundProject:国家自然科学基金（31200633）；安徽省自然科学基金（2008085MH245）；蚌埠医学院"512人才培育计划"项目（by51201211） |
| Author Name | Affiliation | | Zhou Yongchun | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China | | Yang Yaoguo | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China | | Sun Nan | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China | | Xie Lingxiao | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China | | Sun Xianglu | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China | | Li Aoxue | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China | | Wu Qiong | Department of Pathology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China | | Zhang Lei | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China | | Jiang Hao | Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China |
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| Abstract:: |
| Objective To investigate the efficacy of postmastectomy radiotherapy (PMRT) for human epidermal growth factor receptor 2 (HER2)-positive T1-2N1M0 breast cancer in the context of HER2-targeted therapy.Methods This study collected the clinical data of 105 female patients with HER2-positive T1-2N1M0 breast cancer who underwent modified radical mastectomy in the First Affiliated Hospital of Bengbu Medical College from January 2013 to December 2019. Then, the clinical outcomes of these patients were observed, and the prognostic factors and the efficacy of PMRT were analyzed.Results The median follow-up time was 50 months (ranging from 14 to 107 months), and the 5-year overall survival (OS), local-regional recurrence-free survival(LRFS), and disease-free survival (DFS) were 81.6%, 91.9%, and 76.2%, respectively. The multivariate analysis indicated that independent prognostic factors for OS and DFS include the age, pathologic grade, and tumor size; the independent risk factors for LRFS include positive lymph node ratio (LNR) and hormone receptor (HR) status; and the independent prognostic factor for DFS was PMRT (HR:2.85, 95%CI:1.10-8.80, P < 0.05). The subgroup analysis suggested that PMRT significantly improved the OS of various high-risk subgroups (χ2=4.01-9.18, P < 0.05). However, the further stratified analysis indicated that PMRT only increased the OS of the patients who did not receive HER2-targeted therapy in various high-risk subgroups (χ2=4.50-6.70, P < 0.05), while there was no statistical difference before and after PMRT for the individuals who received targeted treatment (P > 0.05).Conclusions PMRT is an independent prognostic factor for the DFS of patients with HER2-positive T1-2N1M0 breast cancer who underwent modified radical mastectomy. PMRT can improve the OS of high-risk patients with ages < 45 years old, pathologic grade Ⅲ, tumor diameter ≥ 3 cm, LNR > 10%, and HR (-) who received no HER2-targeted therapy. However, the efficacy may be compromised to some extent in the context of the application of HER2-targeted therapy. |
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