Omitting radiotherapy in LUMINA-like breast cancer after breast conserving surgery: 10-year results of a population-based cohort study.

IF 4.2 2区医学 Q1 ONCOLOGY

Oncologist Pub Date : 2025-10-22 DOI:10.1093/oncolo/oyaf355

Shenkangle Wang, Ziyu Zhu, Binbin Cui, Mingpeng Luo, Xixi Lin, Zijie Guo, Qingliang Wu, Linbo Wang, Xiaonan Sun, Jichun Zhou

{"title":"Omitting radiotherapy in LUMINA-like breast cancer after breast conserving surgery: 10-year results of a population-based cohort study.","authors":"Shenkangle Wang, Ziyu Zhu, Binbin Cui, Mingpeng Luo, Xixi Lin, Zijie Guo, Qingliang Wu, Linbo Wang, Xiaonan Sun, Jichun Zhou","doi":"10.1093/oncolo/oyaf355","DOIUrl":null,"url":null,"abstract":"Background: Recently, the LUMINA trial reported 5-year results of omitting radiotherapy in a low-risk cohort after breast-conserving surgery (BCS). This study aimed to validate their 5-year results and investigate 10-year outcomes of patients satisfying their criteria in a population-based cohort.Materials and methods: 28,185 eligible patients were identified from the Surveillance, Epidemiology and End Results (SEER) database to establish SEER-LUMINA cohort. The Kaplan-Meier method was employed to estimate recurrence incidence and survival outcomes. Matched cohorts were generated using propensity score matching (PSM). The Cox proportional hazards model was used to generate hazard ratios.Results: 6,808 patients of the 28,185 did not receive radiotherapy while 21,377 underwent postoperative radiotherapy. After PSM, each group had 5,954 patients, revealing significant differences in local recurrence incidence (no-radiotherapy group 0.65% at 5 years and 3.68% at 10 years vs. radiotherapy group 0.14% at 5 years and 1.54% at 10 years, P < 0.001), BCSS (no-radiotherapy group 98.51% at 5 years and 96.11% at 10 years vs. radiotherapy group 99.05% at 5 years and 96.34% at 10 years, P = 0.028). No difference was observed in BCSS between the two groups for SEER-LUMINA patients with tumor ≤1.4 cm (the optimal tumor size cutoff value for BCSS) (P = 0.099).Conclusion: Incidence, whether 5-year or 10-year recurrence, was lower than 5% in the SEER-LUMINA cohort. Radiotherapy following BCS reduced the local recurrence statistically significantly for those patients, but the clinical impact of this reduction was modest. Radiotherapy did not result in a difference in BCSS for SEER-LUMINA patients with tumors ≤1.4 cm.","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2000,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncologist","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/oncolo/oyaf355","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Recently, the LUMINA trial reported 5-year results of omitting radiotherapy in a low-risk cohort after breast-conserving surgery (BCS). This study aimed to validate their 5-year results and investigate 10-year outcomes of patients satisfying their criteria in a population-based cohort.

Materials and methods: 28,185 eligible patients were identified from the Surveillance, Epidemiology and End Results (SEER) database to establish SEER-LUMINA cohort. The Kaplan-Meier method was employed to estimate recurrence incidence and survival outcomes. Matched cohorts were generated using propensity score matching (PSM). The Cox proportional hazards model was used to generate hazard ratios.

Results: 6,808 patients of the 28,185 did not receive radiotherapy while 21,377 underwent postoperative radiotherapy. After PSM, each group had 5,954 patients, revealing significant differences in local recurrence incidence (no-radiotherapy group 0.65% at 5 years and 3.68% at 10 years vs. radiotherapy group 0.14% at 5 years and 1.54% at 10 years, P < 0.001), BCSS (no-radiotherapy group 98.51% at 5 years and 96.11% at 10 years vs. radiotherapy group 99.05% at 5 years and 96.34% at 10 years, P = 0.028). No difference was observed in BCSS between the two groups for SEER-LUMINA patients with tumor ≤1.4 cm (the optimal tumor size cutoff value for BCSS) (P = 0.099).

Conclusion: Incidence, whether 5-year or 10-year recurrence, was lower than 5% in the SEER-LUMINA cohort. Radiotherapy following BCS reduced the local recurrence statistically significantly for those patients, but the clinical impact of this reduction was modest. Radiotherapy did not result in a difference in BCSS for SEER-LUMINA patients with tumors ≤1.4 cm.

查看原文本刊更多论文

保乳手术后lumina样乳腺癌省略放疗：一项基于人群的队列研究的10年结果

背景：最近，LUMINA试验报告了低风险队列保乳手术（BCS）后5年免放疗的结果。本研究旨在验证他们的5年结果，并在以人群为基础的队列中调查满足其标准的患者的10年结果。材料和方法：从监测、流行病学和最终结果（SEER）数据库中确定28,185例符合条件的患者，建立SEER- lumina队列。Kaplan-Meier法用于估计复发率和生存结果。使用倾向评分匹配（PSM）生成匹配队列。采用Cox比例风险模型生成风险比。结果：28185例患者中，6808例未接受放疗，21377例术后接受放疗。PSM后，两组患者共5,954例，局部复发率差异有统计学意义(无放疗组5年0.65%，10年3.68%，放疗组5年0.14%，10年1.54%，P结论：SEER-LUMINA队列5年或10年复发率均低于5%。BCS后放疗显著减少了这些患者的局部复发，但这种减少的临床影响并不大。对于肿瘤≤1.4 cm的SEER-LUMINA患者，放疗没有导致BCSS的差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Oncologist 医学-肿瘤学

CiteScore

10.40

自引率

3.40%

发文量

309

审稿时长

3-8 weeks

期刊介绍： The Oncologist® is dedicated to translating the latest research developments into the best multidimensional care for cancer patients. Thus, The Oncologist is committed to helping physicians excel in this ever-expanding environment through the publication of timely reviews, original studies, and commentaries on important developments. We believe that the practice of oncology requires both an understanding of a range of disciplines encompassing basic science related to cancer, translational research, and clinical practice, but also the socioeconomic and psychosocial factors that determine access to care and quality of life and function following cancer treatment.