이화의대 / 김이준, 김규보*
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.
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