我们评估了乳腺癌患者经济毒性 (FT) 的社会人口统计学和临床​​预测因素，这些患者具有需要区域淋巴结照射 (RNI) 的较高风险临床因素。在常规与大分割 RNI 治疗临床试验的 183 名参与者中，125 名 (68% ）完成了一项 FT 试点调查，使用经过验证的癌症经济压力和恢复力 (ENRICh) 仪器进行测量，FT 评分从 0（最低）到 10（严重）。使用 Pearson 相关系数和 Kruskal Wallis、Mann-Whitney U 和 Jonckheere-Terpstra 检验评估与预测变量的关联。使用多变量逻辑回归测试严重 FT (ENRICh≥5) 的预测因子，并将比值比转换为相对风险 (RR)。在样本中，所有样本均接受 RNI、92% 化疗、67% 腋窝淋巴结清扫术、26% 乳房切除术（未重建），以及32% 乳房切除并重建。中位随访时间为 1.48 年，中位 FT 评分为 2.13 (IQR 0.93-4.6)，20.8% 的患者经历严重 FT。未经调整的较差 FT 评分与年龄较小 (P = 0.003)、西班牙裔 (P = 0.006)、收入较低 (P = 0.02)、从诊断到 FT 评估的间隔较短 (P = 0.02) 以及接受化疗 (P = 0.05），但与乳房手术类型（P = 0.42）、腋窝手术类型（P = 0.33）或病理T分期（P = 0.68）或N分期（P = 0.47）无关。在多变量分析中，三阴性亚型是预测严重 FT 的唯一临床因素（RR = 3.38；95% CI 1.48-4.99；P = 0.01）。在接受 RNI 的乳腺癌患者中，三阴性亚型与严重 FT 相关，表明该肿瘤受体亚型可能有助于识别早期 FT 干预的关键乳腺癌亚群。版权所有 © 2024。由 Elsevier Ltd 出版。

We evaluated sociodemographic and clinical predictors of financial toxicity (FT) among patients with breast cancer with higher risk clinical factors warranting regional nodal irradiation (RNI).Among 183 participants in a clinical trial of conventional vs. hypofractionated treatment with RNI, 125 (68 %) completed a pilot survey of FT measured using the validated Economic Strain and Resilience in Cancer (ENRICh) instrument, scored from 0 (minimal) to 10 (severe) FT. Associations with predictors were evaluated using Pearson correlation coefficients and Kruskal Wallis, Mann-Whitney U, and Jonckheere-Terpstra tests. Predictors of severe FT (ENRICh≥5) were tested using multivariable logistic regression with odds ratios converted to relative risks (RR).Of the sample, all received RNI, 92 % chemotherapy, 67 % axillary dissection, 26 % mastectomy without reconstruction, and 32 % mastectomy with reconstruction. At a median follow up of 1.48 years, median FT score was 2.13 (IQR 0.93-4.6), with 20.8 % of patients experiencing severe FT. Unadjusted worse FT score was associated with younger age (P = 0.003), Hispanic ethnicity (P = 0.006), lower income (P = 0.02), shorter interval from diagnosis to FT assessment (P = 0.02), and chemotherapy receipt (P = 0.05), but not with breast surgery type (P = 0.42), axillary surgery type (P = 0.33), or pathologic T (P = 0.68) or N stage (P = 0.47). In multivariable analysis, triple negative subtype was the sole clinical factor predicting severe FT (RR = 3.38; 95 % CI 1.48-4.99; P = 0.01).Among patients with breast cancer receiving RNI, triple negative subtype was associated with severe FT, suggesting that tumor receptor subtype may help identify a key breast cancer subpopulation for early FT intervention.Copyright © 2024. Published by Elsevier Ltd.