Lancet Oncol:cT1-2N1乳腺癌初始化疗后可根据复发风险进行适应性的降级放疗

2022-08-11 MedSci原创 MedSci原创

在这项研究中,所有乳腺癌患者的 5 年局部区域复发率低于 4%,支持了研究人员的假设,即在接受初次化疗的cT1-2N1期乳腺癌患者中,基于局部区域复发风险降低局部区域放疗剂量在肿瘤学上是安全的。

乳腺癌的初次化疗在辅助局部放疗方面存在两难选择,因为局部放疗的指南最初是基于初次手术的病理结果。该研究目的是根据预先确定的、基于共识的研究指南,评估降级局部放疗对接受初次化疗的cT1-2N1期乳腺癌患者的肿瘤学安全性。

这项前瞻性的注册研究纳入了于2011年1月1日-2015年1月1日期间转诊至荷兰17个放射肿瘤中心之一、并接受了初次化疗和乳腺级腋窝手术治疗的cT1-2N1期乳腺癌患者。研究指南包括三个局部复发风险组,并提供相应的局部放疗建议:低危组不进行胸壁放疗和区域放疗,中危组只进行局部放疗,高危组进行区域放疗。放疗包括 25 次 2 Gy 的生物等效剂量,加量或不加量。主要终点是区域复发率。研究人员假设,5年区域复发率应低于4%。


各风险组患者的局部区域复发率

838位患者符合 5 年随访分析的条件:低危组 291位,中危组 370位,高危组 177位。所有患者的 5 年区域复发率为 2.2%。低危组 、中危组和高危组的5年区域复发率分别是2.1%、2.2%和2.3%。如果遵循研究指南,则低风险组、中风险组和高风险组的局部区域复发率分别是2.3%、1.0%和1.4%。

总之,在这项研究中,所有乳腺癌患者的 5 年局部区域复发率低于 4%,支持了研究人员的假设,即在接受初次化疗的cT1-2N1期乳腺癌患者中,基于局部区域复发风险降低局部区域放疗剂量在肿瘤学上是安全的

 

原始出处:

Sabine R de Wild, et al. De-escalation of radiotherapy after primary chemotherapy in cT1–2N1 breast cancer (RAPCHEM; BOOG 2010–03): 5-year follow-up results of a Dutch, prospective, registry study. The Lancet Oncology. August 08, 2022. https://doi.org/10.1016/S1470-2045(22)00482-X

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1905609, encodeId=6e53190560955, content=<a href='/topic/show?id=0eb34259ea1' target=_blank style='color:#2F92EE;'>#复发风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42597, encryptionId=0eb34259ea1, topicName=复发风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ca20190, createdName=wushaoling, createdTime=Thu Jun 29 06:14:50 CST 2023, time=2023-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866683, encodeId=3819186668393, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Mon Jan 16 19:14:50 CST 2023, time=2023-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831633, encodeId=63481831633a4, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Feb 27 21:14:50 CST 2023, time=2023-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621057, encodeId=e5f5162105ecf, content=<a href='/topic/show?id=dccc94e01c9' target=_blank style='color:#2F92EE;'>#适应性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94701, encryptionId=dccc94e01c9, topicName=适应性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b13a20191510, createdName=huhuaidong394, createdTime=Thu Aug 11 06:14:50 CST 2022, time=2022-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1244073, encodeId=c7f112440e375, content=lancet上果然牛,感谢梅斯更新及时, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=younei, createdTime=Tue Aug 09 18:14:50 CST 2022, time=2022-08-09, status=1, ipAttribution=)]
    2023-01-16 minlingfeng
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    2023-02-27 howi
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    2022-08-09 younei

    lancet上果然牛,感谢梅斯更新及时

    0

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