Postmastectomy Radiation Therapy Based on Pathologic Nodal Status in Clinical Node-Positive Stage II to III Breast Cancer Treated with Neoadjuvant Chemotherapy
| Autor: | Jun Zhang, Liang-Fang Shen, Jian Tie, Hong-Fen Wu, Shulian Wang, Jing Cheng, Xiaobo Huang, Qinglin Rong, Yu-Ting Tan, Weihu Wang, Jiayi Chen, Yexiong Li, Min Liu, Mei Shi, Li Zhu, Chang-Ying Ma, Yu Tang, Zhou Huang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Adult Cancer Research medicine.medical_specialty medicine.medical_treatment Breast Neoplasms Kaplan-Meier Estimate Stage ii Systemic therapy Disease-Free Survival 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Radiology Nuclear Medicine and imaging Propensity Score Pathological Lymph node Mastectomy Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Chemotherapy Radiation business.industry Middle Aged Postmastectomy radiation medicine.disease Neoadjuvant Therapy medicine.anatomical_structure Chemotherapy Adjuvant 030220 oncology & carcinogenesis Lymphatic Metastasis Cohort Lymph Node Excision Female Lymph Nodes business |
| Zdroj: | International journal of radiation oncology, biology, physics. 108(4) |
| ISSN: | 1879-355X |
| Popis: | The present study aimed to evaluate the effect of postmastectomy radiation therapy (PMRT) after neoadjuvant chemotherapy in patients with node-positive stage II to III (cT1-4N1-2M0) breast cancer.A total of 1813 patients from 12 institutions were retrospectively reviewed. Patients were classified into 1 of 3 groups based on the pathologic lymph node status after neoadjuvant chemotherapy: ypN0, ypN1, and ypN2-3. The role of PMRT was separately evaluated in each group. Locoregional control, disease-free survival, and overall survival (OS) were estimated using the Kaplan-Meier method. The effect of PMRT was assessed by propensity score-matched analyses and multivariate Cox analyses.With a median follow-up of 72.9 months, 5-year locoregional control, disease-free survival, and OS rates were 86.3%, 68.4%, and 83.1% for the entire cohort, respectively. There were 490 (27.0%), 567 (31.3%), and 756 (41.7%) patients in the ypN0, ypN1, and ypN2-3 groups, respectively. PMRT significantly improved 5-year OS in the ypN2-3 group (74.2% vs 55.9%; P.001) but had no effect on 5-year OS in the ypN0 group (93.1% vs 95.5%; P = .517) and ypN1 group (88.4% vs 87.8%; P = .549).With modern systemic therapy, PMRT significantly improved OS in the ypN2-3 group but not in the ypN0 and ypN1 groups. Whether PMRT can be safely omitted in the ypN0 and ypN1 groups should be addressed prospectively. |
| Databáze: | OpenAIRE |
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