| Objective: To investigate the clinical value of radiotherapy for patients with type Luminal A in the second stage of T1-2N1 breast cancer after modified radical mastectomy.Methods: A retrospective analysis was performed on 191 patients with type Luminal A in the second stage of T1-2N1 in our department during 2005-2010,who were treated with modified radical mastectomy,11 cases lost.The age of the patients was from 30 to 82 years and the median age was 50 years.45(46.7%)patients were T1 and 75(52.6%)were T2,45(25.0%),75(41.67%)and 60(33.33%) patients have1,2and 3 axillary positive lymph node.All patients did not receive neoadjuvant chemotherapy and endocrine therapy before operation.The patients were divided into the following two groups according to the data collected in the course of treatment,postoperative chemotherapy、radiotherapy and endocrine therapy(133/180)in 133 cases(observation group),postoperative chemotherapy and endocrine therapy(47/180)in patients with 47 cases(control group),to observe the 5 year survival rate of the 2 groups of patients(OS),the 5 year local recurrence rate(LRR),5 years distant metastasis free survival rate(DMF),and the adverse reactions and the adverse reactions in observation group after radiotherapy.SPSS13.0 software was used to analyze the correlation between the 2 groups.Result:The follow deadline is December 31,2016,and the median follow-up time was 35 months.1.The shortest follow time was 10 months,the longest was 60 months,and the overall survival rate was 82.78%(149/180),the first local recurrence are 13 cases,accounting for 7.2%.2.The 5 year survival rate of all patients in the group of was 82.78%(149/180),there was no significant difference in the 5 year survival rate of the two groups of patients(88.72%vs65.96%,P = 0.206,P>0.05),there was significant difference in local recurrence rate(3%vs17.02%,P= 0.0379),and there was significant difference in the rate of metastasis(12.03% vs42.55%,P = 0.0041,P<0.05).3.Tumor size,histological grade,number of positive axillary lymph nodes and lymph node dissection positive lymph node ratio have significant effect on prognosis of breast cancer patients with type LuminalA middle risk group(P<0.05),there were three independent factors in affecting the survival of patients with type LuminalA breast cancer,tumor size,histological grade and number of positive axillary lymph(P=0.001,P=0.034,P=0.023),the overall survival of patients of the stage T1 is better than the stage T2 patients,the difference is significant(P=0.001),the number of positive axillary lymph node(1-2)of the overall survival is less than 3 of the patients,the difference is statistically significant(P=0.023),the grade of tumor(I-II)patients with patient survival than the III grade the difference was statistically significant(P=0.034).4.Patients in the observation group were treated with radiotherapy,such as radiation dermatitis,radiation induced lung injury and bone marrow suppression.Conclusion:1.Postoperative radiotherapy for patients with type Luminal A in the second stage of T1-2N1 breast cancer has no significant effect on the overall survival rate,but it can reduce the local recurrence rate and distant metastasis rate.2.Postoperative radiotherapy can benefit these patients with stage T2,histological grade III,and three positive axillary lymph nodes and it can improve their overall survival without local recurrence.3.Tumor size,the number of positive axillary lymph nodes,and histological grade were independent prognostic factors for survival in patients with type LuminalA breast cancer. |
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