Meme Kanserinde 5 Yıllık Tedavi Sonuçlarımız ve Prognostik Faktörler: Tek Merkez Deneyimi
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Tarih
2017
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info:eu-repo/semantics/openAccess
Özet
Kliniğimizde tedavi edilen olgu serisini retrospektif olarak inceleyerek 5 yıllık sağkalım sonuçlarını ve sağkalımı etkileyen prognostik parametreleri saptamaktır. Meme kanseri tanısıyla başvuran ve kliniğimizin rutin meme prosedürüne göre küratif olarak tedavi olmuş olgu verileri incelenmiştir. Tüm olgular üç boyutlu konformal RT tekniği ile göğüs duvarı veya meme dokusuna karşılıklı paralel tanjansiyel alanlar kullanılarak günlük 2 Gy fraksiyon dozuyla haftada 5 gün olacak şekilde tedavi edilmiştir. Rejyonel lenf nodu bölgesinin tedavi edilmesi gereken durumlarda ise supraklavikuler fossa ışınlaması da tedaviye eklenmiştir. Olgulara sıklıkla antrasiklin bazlı kemoterapi rejimleri uygulanmış olup, östrojen reseptörü pozitif olan olgular hormon tedavisi, Her-2 reseptör pozitif olgular da trastuzumab tedavisi almıştır. Çalışmanın birincil sonlanım noktaları genel sağkalım (GS) ve hastalıksız sağkalım (HS) idi. İkincil sonlanım noktası ise sağkalım süreleri üzerine etkili olan prognostik faktörleri saptamak idi. Tüm istatistiksel analizler SPSS (Statistical Package for Social Sciences) 13 versiyonu kullanılarak yapılmıştır. 11.02.2010- 01.05.2016 tarihleri arasında kliniğimize başvuran toplam 559 meme kanseri olgusu değerlendirilmiştir. 2 ve 5 yıllık GS oranları sırasıyla %97 ve %84; 2 ve 5 yıllık HS oranları sırasıyla %97 ve %71 olarak bulunmuştur. Çok değişkenli analizlerde, 70 yaş, triple (-) olmak, T3-4 evre hastalığa sahip olmak, N2-3 nodal evre hastalığa sahip olmak ve metastaz yada lokal- bölgesel nüks olması GS’ yi olumsuz etkileyen bağımsız prognostik faktörler olarak bulunurken; N2-3 nodal hastalığa sahip olmak ve triple (-) olmak HS’ yi olumsuz etkileyen faktörler olarak saptanmıştır. Meme kanseri dünya genelinde kadınlar arasında görülen en sık kanser türü olup insidansı artmasına rağmen hastalığa bağlı mortalite oranları zamanla düşmeye başlamıştır. Güncel tedavi modaliteleri ışığında prognostik faktörlerin bilinmesi hem en doğru tedavi modalitesinin seçilmesi hem de uygulanan tedavi modalitesine alınacak yanıtın öngörülebilmesi açısından önemlidir.
To evaluate the five year survival outcomes of breast cancer patients treated at our department and to assess the prognostic factors that affect survival parameters. All patients underwent our department’s routine procedure for breast cancer. All patients received RT to the breast or chest wall using 3D conformal technique with 2 Gy fraction doses, five days a week with two opposite tangential fields. If necessary, ipsilateral supraclavicular fossa field was added to the treatment field . Anthracycline -based chemotherapy was primarily used, patients with estrogen receptor- positive disease received hormonal therapy and patients with Her- 2 receptor -positive disease received trastuzumab. The primary end points of this study were to evaluate the overall survival (OS) and the disease-free survival (DFS) of the patients. The secondary end points of this study were to assess the prognostic factors that affect the survival outcomes. Statistical analysis were carried out using SPSS Statistic program version 13. Between 11.02.2010 and 01.05.2016, 559 patients with breast cancer who had been irradiated postoperatively were included in this retrospective study. 2 and 5 year OS rates were 97% and 84%; 2 and 5 year DFS rates were 97% and 71%, respectively. According to multivariate analysis, 70 year, to have triple (-) hormonal status, to have T3-4 disease, to have N2-3 nodal stage and to have locoregional recurrence or distant metastasis were the independent prognostic factors that affect OS. Also, to have N2-3 nodal stage and to have triple (-) hormonal status were independent prognostic factors that affect DFS. Breast cancer is the most common cancer among women. Its incidence has been increasing but mortality has been decreasing in the last 10-15 years . In the light of current treatment modalities, to know the prognostic factors that affect survival outcomes is very important for both choosing the most appropriate treatment modality and the prediciton of treatment response.
To evaluate the five year survival outcomes of breast cancer patients treated at our department and to assess the prognostic factors that affect survival parameters. All patients underwent our department’s routine procedure for breast cancer. All patients received RT to the breast or chest wall using 3D conformal technique with 2 Gy fraction doses, five days a week with two opposite tangential fields. If necessary, ipsilateral supraclavicular fossa field was added to the treatment field . Anthracycline -based chemotherapy was primarily used, patients with estrogen receptor- positive disease received hormonal therapy and patients with Her- 2 receptor -positive disease received trastuzumab. The primary end points of this study were to evaluate the overall survival (OS) and the disease-free survival (DFS) of the patients. The secondary end points of this study were to assess the prognostic factors that affect the survival outcomes. Statistical analysis were carried out using SPSS Statistic program version 13. Between 11.02.2010 and 01.05.2016, 559 patients with breast cancer who had been irradiated postoperatively were included in this retrospective study. 2 and 5 year OS rates were 97% and 84%; 2 and 5 year DFS rates were 97% and 71%, respectively. According to multivariate analysis, 70 year, to have triple (-) hormonal status, to have T3-4 disease, to have N2-3 nodal stage and to have locoregional recurrence or distant metastasis were the independent prognostic factors that affect OS. Also, to have N2-3 nodal stage and to have triple (-) hormonal status were independent prognostic factors that affect DFS. Breast cancer is the most common cancer among women. Its incidence has been increasing but mortality has been decreasing in the last 10-15 years . In the light of current treatment modalities, to know the prognostic factors that affect survival outcomes is very important for both choosing the most appropriate treatment modality and the prediciton of treatment response.
Açıklama
Anahtar Kelimeler
Meme kanseri, Prognostik faktörler, Radyoterapi, Sağkalım sonuçları, Breast cancer, Prognostic factors, Radiotherapy, Survival outcomes
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Cilt
33
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1
