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  • [Sci Rep.] Survival benefit of radiotherapy after surgery in de novo stage IV breast cancer: a population-based propensity-score matched analysis.

    이화의대 / 김이준, 김규보*

  • 출처
    Sci Rep.
  • 등재일
    2019 Jun 12
  • 저널이슈번호
    9(1):8527. doi: 10.1038/s41598-019-45016-2.
  • 내용

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    Abstract
    The survival benefit from radiotherapy in stage IV breast cancer has not been fully evaluated. We investigated the survival benefit of radiotherapy after surgery in de novo stage IV breast cancer. Using a population-based database (the Surveillance, Epidemiology, and End Results database 18, 2010-2013), patients diagnosed with de novo stage IV breast cancer were divided into those undergoing surgery alone (no-radiotherapy group) and those undergoing surgery followed by radiotherapy (radiotherapy group). After propensity-score matching (PSM), the cancer-specific survival (CSS) rates were estimated. Multivariate analysis was performed to evaluate the prognostic value of radiotherapy on survival. After PSM, the 3-year CSS rates in the no-radiotherapy (n = 882) and radiotherapy (n = 882) groups were 57.1% and 70.9% (P < 0.001), respectively. On multivariate analysis, radiotherapy after surgery was a significant prognosticator (hazard ratio [HR] 0.572; 95% confidence interval [CI] 0.472-0.693, P < 0.001). Regardless of surgery type and lymph node involvement, the radiotherapy group showed significantly higher CSS rates. For patients who survived six months or more, radiotherapy after surgery demonstrated favorable prognosis compared to surgery alone (HR 0.593; 95% CI 0.479-0.733, P < 0.001). In conclusion, radiotherapy after surgery increased CSS rates in de novo stage IV breast cancer compared to surgery alone.

     


    Author information

    Kim YJ1,2,3, Jung SY4, Kim K5,6.
    1
    Center for Precision Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
    2
    Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
    3
    Department of Radiation Oncology, Graduate School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
    4
    Center for Breast Cancer, National Cancer Center, Goyang, Gyeonggi, Republic of Korea.
    5
    Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea. kyubokim.ro@gmail.com.
    6
    Department of Radiation Oncology, Graduate School of Medicine, Ewha Womans University, Seoul, Republic of Korea. kyubokim.ro@gmail.com.

  • 연구소개
    SEER data를 이용하여 진단 시 원격전이를 동반한 4기 유방암에서 방사선치료를 시행하는 것이 치료 성적에 어떤 영향을 주는지를 분석한 논문입니다. SEER data의 특성 상 방사선치료의 부위를 알 수 없다는 단점이 있으나, first course treatment로 수술을 시행받고 추가적으로 방사선치료를 받은 환자에서 생존율이 더 높음을 propensity score matched analysis를 이용하여 보여주었습니다.
  • 편집위원

    Initially stage IV breast cancer에서 수술 후 방사선치료의 국소치료가 생존율 향상되었다는 내용으로 임상진료시 치료방법 선태에 근거자료로 도움이 되겠습니다.

    2019-07-18 15:10:10

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