Prognostic Impact of Elective Supraclavicular Nodal Irradiation for Patients with N1 Breast Cancer after Lumpectomy and Anthracycline Plus Taxane-Based Chemotherapy (KROG 1418): A Multicenter Case-Controlled Study.
- Author:
Haeyoung KIM
1
;
Won PARK
;
Jeong Il YU
;
Doo Ho CHOI
;
Seung Jae HUH
;
Yeon Joo KIM
;
Eun Sook LEE
;
Keun Seok LEE
;
Han Sung KANG
;
In Hae PARK
;
Kyung Hwan SHIN
;
Chan Woo WEE
;
Kyubo KIM
;
Kyung Ran PARK
;
Yong Bae KIM
;
Sung Ja AHN
;
Jong Hoon LEE
;
Jin Hee KIM
;
Mison CHUN
;
Hyung Sik LEE
;
Jung Soo KIM
;
Jihye CHA
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Breast neoplasms; Adjuvant radiotherapy; Lymphatic irradiation; Taxane; Case-control studies
- MeSH: Breast Neoplasms*; Breast*; Case-Control Studies*; Disease-Free Survival; Drug Therapy*; Humans; Lymph Nodes; Lymphatic Irradiation; Lymphedema; Mastectomy, Segmental*; Neoplasm Metastasis; Propensity Score; Radiation Pneumonitis; Radiotherapy; Radiotherapy, Adjuvant; Recurrence
- From:Cancer Research and Treatment 2017;49(4):970-980
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy. MATERIALS AND METHODS: We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups. RESULTS: A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI. CONCLUSION: We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.
