Observation Of Efficacy On 295 Cases Of Advanced Breast Cancer Treated With Systemic Threrapy With Or Without Radiotherapy Of Contemporary Or Recurrent Lesions

Objective: The principle of therapy for advanced breast cancer is systemic therapy.However,there are few reports about the efficacy of radiotherapy for recurrence and metastasis.In this study,we retrospectively analyzed the efficacy of chemotherapy concurrent radiotherapy for advanced breast cancer,and explored the value of radiotherapy.Methods:We collected 295 patients with advanced breast cancer diagnosed in our hospital from January 2007 to December 2013,follow-up deadline is September 2016,basing on the comparison of effective systemic chemotherapy concurrent radiotherapy or not,and statistics were overall survival(OS)and progression free survival(PFS).Meanwhile we accessed the quality of life.Results:.1)295 cases of advanced breast cancer patients with metastatic and primary tumor concurrent radiotherapy was performed in 162 cases and nonradiotherapy in 133 cases,all patients were treated with effectively systemic therapy.2)295 patients were followed by telephone and outpatient visits,the median follow-up was 57 months.There was no statistically significant difference in OS between patients with localized radiotherapy and without radiotherapy,P=0.081.The overall progression-free survival rate of radiotherapy group was significantly higher than that of non-radiotherapy group,P=0.01.the difference was statistically significant.Subgroup analysis showed that 27 patients(16.7%)with bone metastasis were treated with radiotherapy alone and 8 patients(6.0%)without.There was no significant difference in the overall survival of patients with bone metastases treated with radiotherapy and without radiotherapy,P=0.592,the difference was not statistically significant.PFS in radiotherapy group was higher than that in non-radiotherapy group,P=0.018 the difference was statistically significant.The progression free survival time of the patients with pulmonary metastasis was higher than that of the non radiotherapy group,the difference was statistically significant(P=0.027).There was no significant difference between OS and PFS in radiotherapy group and non-radiotherapy group with brain and liver metastasis.4)Adverse reactions: Of the 162 patients who received radiotherapy,the most common adverse events were radiation dermatitis and upper gastrointestinal reactions,radiation dermatitis mainly occurs in the recurrence of chest wall patients,accounting for 75% of patients in the whole group.The number of white blood cells and platelet decline mainly for the degree of I and II,all the adverse reactions were relieved after symptomatic treatment.5)Quality of life: Radiotherapy improves the KPS score in patients with bone metastases,and has a good analgesic effect on bone metastases.The pain relief rate of patients with simple bone metastasis is 100% after radiotherapy.At the same time,radiotherapy also improved the KPS score in patients with brain,liver and lung metastasis.Conclusion:Local radiotherapy can improve the PFS of breast cancer patients with bone and lung metastasis,and improve the quality of life,but it has no significant effect on OS,the effect of radiotherapy is accurate while the adverse reaction is small,it is worthy of further promotion in clinical.