ABSTRACT
Objective To explore the effect of prognosis of consolidation radiotherapy for patients after R0 resection of local recurrence after radical mastectomy. Methods Totally 110 breast cancer patients with local recurrence receiving R0 resection were admitted and treated in our hospital from January 1st, 2003 to November 30th, 2015 were retrospectively analyzed. Results The median local progression time of 74 patients receiving consolidation radiotherapy ( 67.3％) was remarkably better than that of those without radiotherapy(36 patients, 32.7％), and the difference was statistically significant (χ2 =8. 526, P<0.05). Meanwhile, there was no statistically significant difference (P>0.05) of distance disease-free survival and overall survival between the radiotherapy group and the non-radiotherapy group. Multifactor analysis indicated that pseudo-adjuvant endocrine therapy (χ2 =7.541,95％CI:27.1％ -80.4％, P <0.05), DDFS(≥2 years vs. <2 years,χ2 =4.068,95％CI:101.4％ -267％,P<0. 05) and pseudo-adjuvant radiotherapy(χ2 =14.126, 95％CI:21.7％ -80.4％, P <0. 05 ) were the independent risk factors affecting the OS of patients with local recurrence after R0 resection. Conclusions For the patients with local recurrence after R0 resection of local recurrence, it is recommended that consolidation radiotherapy should be done and the radiation field should include the same side of the chest wall and clavicle area lymphatic drainage area.
ABSTRACT
Objective To investigate the value of post-mastectomy radiotherapy ( PMRT ) in patients with T3 N0 breast cancer ( BC ) who were treated with modified radical mastectomy ( MRM ) . Methods A retrospective analysis was performed on the clinical data of BC patients treated with MRM from 1997 to 2014. The inclusion criteria were as follows:( 1 ) female patients;( 2 ) pathological diagnosis of invasive BC;(3) tumor volume greater than 5 cm without axillary lymph node metastasis;(4) the patients who received no neoadjuvant chemotherapy or endocrine therapy and had no distant metastasis or other second primary cancers. A total of 78 patients met the inclusion criteria. Forty patients ( 51%) received PMRT and sixty-seven patients (86%) received adjuvant chemotherapy. The Kaplan-Meier method was used to calculate overall survival ( OS ) , disease-free survival ( DFS ) ( DFS ) , and local-regional recurrence ( LRR) rates, and survival differences between groups were analyzed by the log-rank test. Results The median follow-up time was 79 months ( 6-232 months) . For all patients, the 5-year OS, DFS, and LRR rates were 89%, 87%, and 2%, respectively. The 5-year DFS, OS and LRR rates for radiotherapy group were 84%, 84% and 0%, respectively, versus 91%( P= 0641 ) , 96%( P= 0126 ) , and 5% for non-radiotherapy group. Only estrogen receptor/progesterone receptor ( ER/PR) status and molecular type had significant impacts on DFS ( P=0002 and 0031, respectively) . One patient in non-radiotherapy group had chest wall recurrence. Conclusions MRM is effective in reducing LRR in T3 N0 M0 BC patients. Only ER/PR status and molecular type significantly influence DFS. Effective systemic therapy may be helpful for some T3 N0 patients to avoid chest wall and supraclavicular radiotherapy after MRM, but large-sample studies are needed to further confirm this conclusion.
ABSTRACT
Objective To investigate the value of post-mastectomy radiotherapy ( PMRT ) in patients with T3 N0 breast cancer ( BC ) who were treated with modified radical mastectomy ( MRM ) . Methods A retrospective analysis was performed on the clinical data of BC patients treated with MRM from 1997 to 2014. The inclusion criteria were as follows:( 1 ) female patients;( 2 ) pathological diagnosis of invasive BC;(3) tumor volume greater than 5 cm without axillary lymph node metastasis;(4) the patients who received no neoadjuvant chemotherapy or endocrine therapy and had no distant metastasis or other second primary cancers. A total of 78 patients met the inclusion criteria. Forty patients ( 51%) received PMRT and sixty-seven patients (86%) received adjuvant chemotherapy. The Kaplan-Meier method was used to calculate overall survival ( OS ) , disease-free survival ( DFS ) ( DFS ) , and local-regional recurrence ( LRR) rates, and survival differences between groups were analyzed by the log-rank test. Results The median follow-up time was 79 months ( 6-232 months) . For all patients, the 5-year OS, DFS, and LRR rates were 89%, 87%, and 2%, respectively. The 5-year DFS, OS and LRR rates for radiotherapy group were 84%, 84% and 0%, respectively, versus 91%( P= 0641 ) , 96%( P= 0126 ) , and 5% for non-radiotherapy group. Only estrogen receptor/progesterone receptor ( ER/PR) status and molecular type had significant impacts on DFS ( P=0002 and 0031, respectively) . One patient in non-radiotherapy group had chest wall recurrence. Conclusions MRM is effective in reducing LRR in T3 N0 M0 BC patients. Only ER/PR status and molecular type significantly influence DFS. Effective systemic therapy may be helpful for some T3 N0 patients to avoid chest wall and supraclavicular radiotherapy after MRM, but large-sample studies are needed to further confirm this conclusion.