老年女性乳腺癌患者的治疗方式及影响因素分析

Treatment Methods for Elderly Women with Breast Cancer and Its Influencing Factors

目的：探讨老年女性乳腺癌患者治疗方式及影响因素分析。方法回顾性分析2009年5月至2012年11月在我院普通外科收治的原发性乳腺癌患者116例,统计患者年龄、治疗方式、病理分期、合并症和生存率等,并对患者治疗方式及影响因素进行分析。结果单因素分析显示,年龄、病理类型、 pR表达情况和合并症是乳腺癌患者化疗的影响因素,差异具有统计学意义（x2=4.366、6.353、3.869、9.122, P〈0.05）；年龄、淋巴结转移、手术方式、病理分期是乳腺癌患者放疗的影响因素（x2=3.942、15.225、11.261、20.869, P〈0.05）；多因素分析显示,年龄（95%CI：0.193~0.968）、病理类型（95%CI：0.302~0.910）、 pR表达（95%CI：0.114~0.754）及合并症有无（95%CI：0.107~0.634）均是乳腺癌患者化疗的影响因素（P均〈0.05）；年龄（95%CI：0.029~0.833）、手术方式（95%CI：0.003~0.099）及淋巴结转移（95%CI：0.882~11.191）是乳腺癌患者放疗的影响因素（P均〈0.05）；3年无复发生存率为89.66%（104/116）,3年总生存率为91.38%（106/116）。 logistic多因素分析显示内分泌治疗、淋巴结转移与老年乳腺癌患者的3年无复发生存率有关（P〈0.05）,年龄与老年乳腺癌患者的3年总生存率有关（P〈0.05）。结论手术切除病灶结合放疗仍是最主要有效的治疗手段；年龄是老年患者选择放化疗的影响因素,与患者3年生存率有关；内分泌治疗及手术方式在老年乳腺癌患者中无明显差异,内分泌治疗、淋巴结转移与老年乳腺癌患者的3年无复发生存率有关。

Objective To investigate the treatment methods for elderly women with breast cancer and analyze its influencing fac-tors. Methods 116 cases of patients with primary breast cancer treated in our hospital from May 2009 to November 2012 were retro-spectively analyzed. The differences in age, treatment methods, pathological stages, complications and survival rates of the patients were recorded to analyze the treatment methods and influencing factors of the patients. Results Simple-variable analysis indicated that age, pathological type, pR expression and complication were the influencing factors of chemotherapy for patients with breast canc-er, and the differences were statistically significant （x2=4. 366, 6. 353, 386. 9, 9. 122, P〈0. 05）, age, lymph node metastasis, type of surgery, pathological stage, were the influencing factors for breast cancer patients treated with radiotherapy （ x2 =3. 942, 15. 225, 11. 261, 20. 869, P〈0. 05）. Multivariate analysis showed that the expression of age （95% CI：0. 193~0. 968）, patholog-ical type （95% CI：0. 302~0. 910）, pR expression （95% CI：0. 114~0. 754） and complication （95% CI：0. 107~0. 634） were the factors influencing chemotherapy for patients with breast cancer （ P〈0. 05 ） . While age （ 95% CI： 0. 029 ~0. 833 ） , operation method （95% CI：0. 003~0. 099） and lymph node metastasis （95% CI：0. 882~11. 191） were the influencing factors for patients treated with radiotherapy （P〈0. 05）. The 3-year relapse-free survival rate was 89. 66% （104/116）, and the overall survival rate was 91. 38% （106/116）. Logistic analysis showed that endocrine therapy and lymph node metastasis were related to the 3-year re-lapse-free survival rate （P〈0. 05）, and the age was related to the 3-year overall survival rate （P〈0. 05）. Conclusion The surgery combined with radiotherapy is still the most effective treatment method. Age is the influencing factor for the elderly patients treated with radiotherapy or chemotherapy, which is related to the 3-year survival rate. No significant differences are found in endocrine therapy or operation methods for elderly patients with breast cancer, while the endocrine therapy and lymph node metastasis are connected to the 3-year relapse-free survival rate.