This study aimed to evaluate the role of post-mastectomy radiotherapy (PMRT) in T1-2N1 breast cancer. Between 2006 and 2014, a total of 504 patients with T1-2N1 breast cancer were analyzed. PMRT was administered to 71 patients, and 1:2 propensity score matching (PSM) was performed between the PMRT and non-PMRT groups. Loco-regional control (LRC), disease-free survival (DFS), and overall survival (OS) rates were compared according to PMRT status. Thirteen and one loco-regional recurrences were observed in the PMRT and non-PMRT groups, respectively. Before PSM, the 8-year LRC, DFS, and OS rates in the non-PMRT and PMRT groups were 98.5% and 96.5% (p= 0.426), 89.7% and 91.2% (p= 0.700), and 91.5% and 92.1% (p= 0.679), respectively. Corresponding rates were 95.6% and 96.5% (p= 0.365), 84.1% and 91.2% (p= 0.185), and 88.4% and 92.1% (p= 0.276), respectively, after PSM. Multivariate analysis showed that three lymph node metastases were prognostic for LRC and DFS rates and LVI for OS rate. Arm lymphedema developed in 32.4% of patients who received PMRT, which was significantly higher than the non-PMRT group (p< 0.001). Contributions of PMRT for improvement of treatments outcomes in T1-2N1 breast cancer patients were not evident, while the incidence of arm lymphedema significantly increased after PMRT. Further prospective trials are required to re-evaluate the role of PMRT.
本研究旨在评估乳房切除术后放疗（PMRT）在T1-2N1期乳腺癌治疗中的作用。研究分析了2006年至2014年间共504例T1-2N1期乳腺癌患者，其中71例接受了PMRT治疗。通过1:2倾向评分匹配法对PMRT组与非PMRT组进行匹配，并根据PMRT状态比较局部区域控制率、无病生存率和总生存率。结果显示，PMRT组与非PMRT组分别观察到13例和1例局部区域复发。匹配前，非PMRT组与PMRT组的8年局部区域控制率分别为98.5%和96.5%（p=0.426），无病生存率分别为89.7%和91.2%（p=0.700），总生存率分别为91.5%和92.1%（p=0.679）。匹配后，对应数据分别为95.6%和96.5%（p=0.365）、84.1%和91.2%（p=0.185）、88.4%和92.1%（p=0.276）。多变量分析显示，三枚淋巴结转移是局部区域控制率和无病生存率的预后因素，而淋巴血管侵犯是总生存率的预后因素。接受PMRT治疗的患者中32.4%出现上肢淋巴水肿，显著高于非PMRT组（p<0.001）。研究表明，PMRT对改善T1-2N1期乳腺癌患者治疗结局的作用不明显，但显著增加了上肢淋巴水肿的发生率，需进一步开展前瞻性试验以重新评估PMRT的治疗价值。
肿瘤(癌症)患者之家