Prognostic value of sequencing of radiotherapy and chemotherapy following breast-conserving surgery for patients with breast cancer

Qiuzi Zhong; Zhi Wang; Yu Tang; Qinlin Rong; Shulian Wang; Jing Jin; Weihu Wang; Yueping Liu; Yongwen Song; Hui Fang; Bo Chen; Shunan QI; Ning LI; Yuan Tang; Jianghu Zhang; Yexiong LI

Return

Prognostic value of sequencing of radiotherapy and chemotherapy following breast-conserving surgery for patients with breast cancer

VernacularTitle: 乳腺癌保乳术后放化疗顺序对患者预后的影响
Author: Qiuzi ZHONG ¹ ; Zhi WANG ¹ ; Yu TANG ¹ ; Qinlin RONG ¹ ; Shulian WANG ¹ ; Jing JIN ¹ ; Weihu WANG ¹ ; Yueping LIU ¹ ; Yongwen SONG ¹ ; Hui FANG ¹ ; Bo CHEN ¹ ; Shunan QI ¹ ; Ning LI ¹ ; Yuan TANG ¹ ; Jianghu ZHANG ¹ ; Yexiong LI ¹
Author Information

1. Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China
Publication Type:Clinical Trail
Keywords: Breast neoplasms; Radiotherapy; Chemotherapy, adjuvant; Prognosis
From: Chinese Journal of Oncology 2017;39(4):308-314
CountryChina
Language:Chinese
Abstract: Objective:To evaluate the prognostic value of sequencing of adjuvant radiotherapy and chemotherapy following breast-conserving surgery for patients with breast cancer.
Methods:A total of 1 154 patients withT1-2N0-3M0 breast cancer retrospectively reviewed. All patients received sequential radiotherapy and chemotherapy following breast-conserving surgery. Among them, 603 patients received radiotherapy first and 551 patients received chemotherapy first. Log-rank tests were used to determine significance of disease-free survival (DFS) and overall survival (OS) rates in the Kaplan-Meier curve.
Results:The 5-year DFS and OS rates for all patients were 93.0% and 97.8%. The 5-year OS rate was 98.6% in the radiotherapy first group and 96.4% in the chemotherapy first group (P=0.191), and the corresponding DFS rate was 92.7% and 93.2% (P=0.430), respectively. Among the patients with Luminal A subtype, the 5-year OS rate was 99.6% in the radiotherapy first group and 97.8% in the chemotherapy first group (P=0.789). Among the patients with Luminal B subtype, the 5-year OS rate was 94.2% and 96.0%, respectively (P=0.680). Among the patients with triple negative breast cancer, the 5-year OS rate was 100% and 90.9%, respectively, with statistically significant differences (P=0.019). Among the patients with HER-2 positive breast cancer, The 5-year DFS rate was 80.1% and 100%, respectively (P=0.045).
Conclusions:The OS and DFS rates in the chemotherapy first group are not significantly different from those of radiotherapy first group after breast-conserving surgery. Patients with HER-2 positive breast cancer in chemotherapy first group have a much higher DFS rate than that of radiotherapy first group, whereas patients with triple negative breast cancer in radiotherapy first group have a better OS rate than that of chemotherapy first group. Further research is warranted to investigate the benefit of different molecular types in different sequencing of radiotherapy and chemotherapy after breast-conserving surgery.