The role of radiotherapy in HER2+ early-stage breast cancer patients after breast-conserving surgery
BackgroundDue to radioresistance, some HER2+ patients may gain limited benefit from radiotherapy (RT) after breast-conserving surgery (BCS). This study aimed to develop an individualized nomogram to identify early-stage HER2+ patients who could omit RT after BCS.MethodsThe data of HER2+ patients wit...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.903001/full |
| _version_ | 1797961977307332608 |
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| author | Huanzuo Yang Huanzuo Yang Mengxue Qiu Mengxue Qiu Yu Feng Yu Feng Nan Wen Nan Wen Jiao Zhou Jiao Zhou Xiangquan Qin Xiangquan Qin Juan Li Juan Li Xinran Liu Xinran Liu Xiaodong Wang Xiaodong Wang Zhenggui Du Zhenggui Du |
| author_facet | Huanzuo Yang Huanzuo Yang Mengxue Qiu Mengxue Qiu Yu Feng Yu Feng Nan Wen Nan Wen Jiao Zhou Jiao Zhou Xiangquan Qin Xiangquan Qin Juan Li Juan Li Xinran Liu Xinran Liu Xiaodong Wang Xiaodong Wang Zhenggui Du Zhenggui Du |
| author_sort | Huanzuo Yang |
| collection | DOAJ |
| description | BackgroundDue to radioresistance, some HER2+ patients may gain limited benefit from radiotherapy (RT) after breast-conserving surgery (BCS). This study aimed to develop an individualized nomogram to identify early-stage HER2+ patients who could omit RT after BCS.MethodsThe data of HER2+ patients with T0-2N0M0 breast cancer after BCS between 2010 and 2015 were extracted from Surveillance, Epidemiology, and End Results (SEER). Based on the independent prognostic factors determined by the Cox analysis in patients without RT after propensity score matching (PSM), the nomogram and risk stratification model were constructed, and then the prognosis of patients with and without RT was compared in each stratified group.ResultsA total of 10799 early-stage HER2+ patients after BCS were included. Baseline characteristics were similar between groups after PSM. Multivariate Cox analysis indicated that RT could improve overall survival (OS) (HR: 0.45, P<0.001) and breast cancer-specific survival (BCSS) (HR: 0.53, P<0.001). Age, marital status, tumor location, tumor size, and chemotherapy were identified by multivariate Cox analysis in patients without RT and were incorporated into a well-validated nomogram. The risk stratification model based on the nomogram indicated that RT was associated with improved OS (HR 0.40, P< 0.001) and BCSS (HR 0.39, P< 0.001) in the high-risk group but not in the low-risk group [OS: HR 1.04, P = 0.94; BCSS: HR 1.06, P = 0.93].ConclusionRT could significantly improve the OS and BCSS of HER2+ early-stage breast cancer patients after BCS on the whole. For high-risk patients, RT is an essential component of cancer therapy. However, the omission of radiotherapy may be considered for low-risk HER2+ early-stage patients. Further validation and improvement of the nomogram by prospective study or randomized controlled trials are warranted. |
| first_indexed | 2024-04-11T01:06:13Z |
| format | Article |
| id | doaj.art-3479e452b04b41d091d54b15d29ac68a |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T01:06:13Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-3479e452b04b41d091d54b15d29ac68a2023-01-04T11:39:35ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-01-011210.3389/fonc.2022.903001903001The role of radiotherapy in HER2+ early-stage breast cancer patients after breast-conserving surgeryHuanzuo Yang0Huanzuo Yang1Mengxue Qiu2Mengxue Qiu3Yu Feng4Yu Feng5Nan Wen6Nan Wen7Jiao Zhou8Jiao Zhou9Xiangquan Qin10Xiangquan Qin11Juan Li12Juan Li13Xinran Liu14Xinran Liu15Xiaodong Wang16Xiaodong Wang17Zhenggui Du18Zhenggui Du19Breast Disease Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Breast Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBreast Disease Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Breast Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBreast Disease Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Breast Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBreast Disease Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Breast Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBreast Disease Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Breast Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBreast Disease Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Breast Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBreast Disease Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Breast Surgery, Sichuan Academy of Medical Sciences, Sichuan Province People’s Hospital, Chengdu, ChinaBreast Disease Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Breast Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBreast Disease Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Breast Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBreast Disease Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Breast Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBackgroundDue to radioresistance, some HER2+ patients may gain limited benefit from radiotherapy (RT) after breast-conserving surgery (BCS). This study aimed to develop an individualized nomogram to identify early-stage HER2+ patients who could omit RT after BCS.MethodsThe data of HER2+ patients with T0-2N0M0 breast cancer after BCS between 2010 and 2015 were extracted from Surveillance, Epidemiology, and End Results (SEER). Based on the independent prognostic factors determined by the Cox analysis in patients without RT after propensity score matching (PSM), the nomogram and risk stratification model were constructed, and then the prognosis of patients with and without RT was compared in each stratified group.ResultsA total of 10799 early-stage HER2+ patients after BCS were included. Baseline characteristics were similar between groups after PSM. Multivariate Cox analysis indicated that RT could improve overall survival (OS) (HR: 0.45, P<0.001) and breast cancer-specific survival (BCSS) (HR: 0.53, P<0.001). Age, marital status, tumor location, tumor size, and chemotherapy were identified by multivariate Cox analysis in patients without RT and were incorporated into a well-validated nomogram. The risk stratification model based on the nomogram indicated that RT was associated with improved OS (HR 0.40, P< 0.001) and BCSS (HR 0.39, P< 0.001) in the high-risk group but not in the low-risk group [OS: HR 1.04, P = 0.94; BCSS: HR 1.06, P = 0.93].ConclusionRT could significantly improve the OS and BCSS of HER2+ early-stage breast cancer patients after BCS on the whole. For high-risk patients, RT is an essential component of cancer therapy. However, the omission of radiotherapy may be considered for low-risk HER2+ early-stage patients. Further validation and improvement of the nomogram by prospective study or randomized controlled trials are warranted.https://www.frontiersin.org/articles/10.3389/fonc.2022.903001/fullHER2+ breast cancerbreast-conserving surgeryradiotherapyradioresistancenomogramSEER program |
| spellingShingle | Huanzuo Yang Huanzuo Yang Mengxue Qiu Mengxue Qiu Yu Feng Yu Feng Nan Wen Nan Wen Jiao Zhou Jiao Zhou Xiangquan Qin Xiangquan Qin Juan Li Juan Li Xinran Liu Xinran Liu Xiaodong Wang Xiaodong Wang Zhenggui Du Zhenggui Du The role of radiotherapy in HER2+ early-stage breast cancer patients after breast-conserving surgery Frontiers in Oncology HER2+ breast cancer breast-conserving surgery radiotherapy radioresistance nomogram SEER program |
| title | The role of radiotherapy in HER2+ early-stage breast cancer patients after breast-conserving surgery |
| title_full | The role of radiotherapy in HER2+ early-stage breast cancer patients after breast-conserving surgery |
| title_fullStr | The role of radiotherapy in HER2+ early-stage breast cancer patients after breast-conserving surgery |
| title_full_unstemmed | The role of radiotherapy in HER2+ early-stage breast cancer patients after breast-conserving surgery |
| title_short | The role of radiotherapy in HER2+ early-stage breast cancer patients after breast-conserving surgery |
| title_sort | role of radiotherapy in her2 early stage breast cancer patients after breast conserving surgery |
| topic | HER2+ breast cancer breast-conserving surgery radiotherapy radioresistance nomogram SEER program |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.903001/full |
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