关键词: 老年, 乳腺肿瘤, 治疗方式, 药物疗法, 放射疗法, 合并症

Abstract:

Objective To analyze the tendency of elderly patients with breast cancer in the choice of treatment methods and related influencing factors. Methods The data of 312 elderly patients with unilateral breast cancer treated in Yuncheng Central Hospital from January 2013 to December 2017 were collected for retrospective analysis. All patients' treatment options were analyzed，and the age of patients who chose different treatment options was compared. Univariate and logistic regression were used to analyze the chemotherapy choice tendency of elderly breast cancer patients，and Cox proportional risk model was used to analyze the influencing factors of 5-year survival of elderly breast cancer patients. Results In the whole patient population，the selection rates of surgery，chemotherapy，radiotherapy，endocrine therapy and targeted therapy were respectively 97.44% （304/312），81.41% （254/312），7.05% （22/312），68.27% （213/312），3.85% （32/312）. The mean age of all patients was （67.94±6.55） years. There were no statistically significant differences in the age of patients with different treatment methods （all P>0.05）. The results of univariate analysis showed that，there were statistically significant differences in the depth of invasive cancer （t=3.11，P=0.002），number of axillary lymph node metastasis （t=6.54，P<0.001），comorbidities （t=-4.85，P<0.001） and Eastern Cooperative Oncology Group （ECOG） score （t=-4.56，P<0.001） between chemotherapy and non-chemotherapy patients，and there were no statistically significant differences in age （t=-0.52，P=0.604），pathological type （χ²=4.96，P=0.084），surgical type （χ²=0.21，P=0.899），tumor differentiation degree （χ²=3.28，P=0.194），estrogen receptor （χ²=0.99，P=0.321），progesterone receptor （χ²=0.89，P=0.346），and human epidermal growth factor receptor-2 （χ²=0.58，P=0.445）. The results of multifactor analysis showed that types of comorbidities （OR=0.91，95%CI： 0.85-0.99，P=0.024） and ECOG score （OR=0.95，95%CI： 0.92-0.99，P=0.007） were independent influencing factors for the use of chemotherapy after surgery in elderly breast cancer patients. A total of 74 patients died within 5 years after surgery，and the 5-year overall survival rate was 76.28%. More axillary lymph node metastasis （RR=1.26，95%CI： 1.09-1.46，P=0.001） and more complications （RR=1.07，95%CI： 1.02-1.13，P=0.007） were risk factors for prognosis. Conclusion Surgery and chemotherapy are the main treatment methods for elderly patients with breast cancer. ECOG score and number of complications can directly affect the results of chemotherapy selection for such patients，the number of axillary lymph node metastasis and complications had significant influence on the long-term survival of the patients.

Key words: Old age, Breast neoplasms, Treatment mode, Chemotherapy, Radiotherapy, Complication