Radiotherapy
Analysis of the prognostic factors and the value of radiotherapy in the early stage triple-negative breast cancer
Feng Zhang, Zhuo Zhang, Lijuan Zou, Wei Xuan
Published 2018-07-25
Cite as Chin J Radiol Med Prot, 2018, 38(7): 510-516. DOI: 10.3760/cma.j.issn.0254-5098.2018.07.006
Abstract
ObjectiveTo 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.
MethodsThe 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.
ResultsThe 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).
ConclusionsPostoperative 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.
Key words:
Triple-negative breast cancer; Postoperative radiotherapy; Prognosis
Contributor Information
Feng Zhang
Department of Radiotherapy, Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China
Zhuo Zhang
Department of Radiotherapy, Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China
Lijuan Zou
Department of Radiotherapy, Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China
Wei Xuan
Department of Radiotherapy, Shuyang People＇s Hospital, Shuyan 223600, China
