Role of radiotherapy and prognostic factors in breast cancer patients at high-risk of recurrence trea-ted with modified radical mastectomy and chemotherapy
10.3760/cma.j.isan.1004-4221.2009.06.466
- VernacularTitle:乳腺癌改良根治术后复发高危患者的放疗结果和预后因素分析
- Author:
Shulian WANG
;
Zihao YU
;
Yexiong LI
;
Yuan TANG
;
Shunan QI
;
Jianzhong CAO
;
Wenqing WANG
;
Tao LI
;
Jing JIN
;
Weihu WANG
;
Yongwen SONG
;
Xinfan LIU
- Publication Type:Journal Article
- Keywords:
Breast neoplasms/surgery;
Breast neoplasms/radiotherapy;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2009;18(6):466-469
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the outcome and prognostic factors in breast cancer at high-risk of recurrence and evaluate the role of radiotherapy. Methods 381 breast cancer patients treated with mastec-tomy and axillary dissection were retrospectively analyzed. The including criterias were pathologic diagnosis of invasive breast cancer, T_3-T_4 and/or four or more positive axillary nodes. The survival rates was calculat-ed by Kaplan-Meier method, and compared by Logrank test. Cox regression model was used to select poten-tial prognostic variables. Results The median follow up was 48 months. The 5-year overall survival (OS) and locoregional recurrence-free survival (LRFS) rates were 76.8% and 89.7%, respectively. Radiothera-py significantly improved the OS (80.9% vs. 62.3%, χ~2=15.47, P=0.001) and LRFS (93.4% vs. 77.1% χ~2=19.95,P=0.000). The use of ipsilateral chest wall and supraclavicular nodal radiation was associated with increased 5-year chest wall recurrence free survival (96.8% : 86.2%, χ~2= 12.66, P=0.001) and 5-year supraclavicular node recurrence free survival (97.7% : 90.7 %, χ~2= 9.98, P=0.002).However, axillary irradiation had no impact on 5-year axillary recurrence free survival (98.4% : 96.1% ,χ~2=0.74, P=0.389). In multivariate analysis, absence of radiotherapy (χ~2=14.42, P=0.000), 10 or more positive axillary nodes (χ~2=21.60, P=0.000), and T_4 stage (χ~2=10.79, P=0.001) were inde-pendent unfavorable prognostic factors for overall survival. Conclusions Radiotherapy improves the overall survival of breast cancer patients with T_3, T_4 and/or four or more positive axillary nodes. The chest wall and supraclavicular nodal radiation should be given to this group of patients.
