Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press99310.17650/1994-4098-2022-18-3-24-28MAMMOLOGY. ORIGINAL REPORTSМАММОЛОГИЯ. ОРИГИНАЛЬНЫЕ СТАТЬИLong-term oncological outcomes of organ-sparing treatment of patients with early breast cancer aged 65 years and older who had no postoperative radiation therapyОтдаленные онкологические результаты органосохраняющего лечения без послеоперационной лучевой терапии у больных ранним раком молочной железы старше 65 летOrtabaevaD.  R.ОртабаеваД. Р.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284

https://orcid.org/0000-0001-7141-2502ZikiryakhodzhaevA. D. ЗикиряходжаевА. Д.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284

Build. 2, 8 Trubetskaya St., Moscow 119991

8 Miklukho-Maklaya St., Moscow 117198

125284 Москва, 2-й Боткинский проезд, 3

119991 Москва, ул. Трубецкая, 8, стр. 2

117198 Москва, ул. Миклухо-Маклая, 8

RasskazovaE. A.РассказоваЕ. А.
Russian Federation

Elena Aleksandrovna Rasskazova 

3 2nd Botkinskiy Proezd, Moscow 125284

Елена Александровна Рассказова 

125284 Москва, 2-й Боткинский проезд, 3

rasskaz2@yandex.ruSaribekyanE. K. СарибекянЭ. К.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284

125284 Москва, 2-й Боткинский проезд, 3

KaprinA. D.КапринА. Д.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284

8 Miklukho-Maklaya St., Moscow 117198

125284 Москва, 2-й Боткинский проезд, 3

117198 Москва, ул. Миклухо-Маклая, 8

P.A. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of RussiaМосковский научно-исследовательский онкологический институт им. П. А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииI.M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава РоссииInstitute of Medicine, Peoples’ Friendship University of RussiaФГАОУ ВО «Российский университет дружбы народов»0212202218324280112202201122022https://ojrs.abvpress.ru/ojrs/article/view/993

Postoperative radiation therapy after breast-conserving surgery is a standard method of treating breast cancer, but recently the issue of its de-escalation in patients older than 65 due to concomitant pathology, lower life expectancy and possible development of post-radiation complications has been discussed. The results of some foreign studies prove the absence of a statistically significant difference in relapse-free and overall survival in patients with early breast cancer older than 65 years with relatively favorable clinical and morphological characteristics without postoperative radiation therapy. We analyzed the long-term oncological results in patients with breast cancer older than 65 years after breast-conserving surgery without postoperative radiation therapy. The results of the study showed that postoperative radiation therapy in patients over 65 years of age with stage IA pT1N0M0 breast cancer of luminal immunophenotype A does not improve long-term oncological indicators. Thus, the exclusion of postoperative radiation therapy from the treatment plan of this group of patients is oncologically safe and economically justified.

Послеоперационная лучевая терапия после органосохраняющих операций является стандартным методом лечения рака молочной железы (РмЖ), однако в последнее время обсуждается вопрос о ее деэскалации у больных старше 65 лет в связи с сопутствующей патологией, меньшей ожидаемой продолжительностью жизни и возможным развитием постлучевых осложнений. Результаты некоторых зарубежных исследований доказывают отсутствие статистически значимой разницы в безрецидивной и общей выживаемости у больных ранним РмЖ старше 65 лет с относительно благоприятными клинико-морфологическими характеристиками без послеоперационной лучевой терапии. Нами проведен анализ отдаленных онкологических результатов у больных РмЖ старше 65 лет после органосохраняющего хирургического лечения без послеоперационной лучевой терапии. Результаты исследования показали, что проведение послеоперационной лучевой терапии у больных старше 65 лет при IA стадии pT1N0M0 РмЖ люминального иммунофенотипа а не улучшает отдаленные онкологические показатели. таким образом, исключение послеоперационной лучевой терапии из плана лечения данной группы больных является онкологически безопасным и экономически обоснованным.

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