Impact of Regional Nodal Irradiation for Breast Cancer Patients with Supraclavicular and/or Internal Mammary Lymph Node Involvement: A Multicenter, Retrospective Study (KROG 16-14) / Journal of the Korean Cancer Association, 대한암학회지
Cancer Research and Treatment
;
: 1500-1508, 2019.
Article
in English
| WPRIM
| ID: wpr-763211
ABSTRACT
PURPOSE:
The purpose of this study was to evaluate the treatment outcomes of radiotherapy (RT) for breast cancer with ipsilateral supraclavicular (SCL) and/or internal mammary (IMN) lymph node involvement. MATERIALS ANDMETHODS:
A total of 353 patients from 11 institutions were included. One hundred and thirty-six patients had SCL involvement, 148 had IMN involvement, and 69 had both. All patients received neoadjuvant systemic therapy followed by breast-conserving surgery or mastectomy, and postoperative RT to whole breast/chest wall. As for regional lymph node irradiation, SCL RT was given to 344 patients, and IMN RT to 236 patients. The median RT dose was 50.4 Gy.RESULTS:
The median follow-up duration was 61 months (range, 7 to 173 months). In-field progression was present in SCL (n=20) and/or IMN (n=7). The 5-year disease-free survival (DFS) and overall survival rates were 57.8% and 75.1%, respectively. On multivariate analysis, both SCL/IMN involvement, number of axillary lymph node ≥ 4, triple-negative subtype, and mastectomy were significant adverse prognosticators for DFS (p=0.022, p=0.001, p=0.001, and p=0.004, respectively). Regarding the impact of regional nodal irradiation, SCL RT dose ≥ 54 Gy was not associated with DFS (5-year rate, 52.9% vs. 50.9%; p=0.696) in SCL-involved patients, and the receipt of IMN RT was not associated with DFS (5-year rate, 56.1% vs. 78.1%; p=0.099) in IMN-involved patients.CONCLUSION:
Neoadjuvant chemotherapy followed by surgery and postoperative RT achieved an acceptable in-field regional control rate in patients with SCL and/or IMN involvement. However, a higher RT dose to SCL or IMN RT was not associated with the improved DFS in these patients.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Radiotherapy
/
Breast
/
Breast Neoplasms
/
Mastectomy, Segmental
/
Multivariate Analysis
/
Survival Rate
/
Retrospective Studies
/
Follow-Up Studies
/
Disease-Free Survival
/
Drug Therapy
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Cancer Research and Treatment
Year:
2019
Type:
Article
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