Efficacy and prognostic analysis of chest wall boost radiotherapy in stage T 4 breast cancer patients after modified radical mastectomy
10.3760/cma.j.cn113030-20190709-00005
- VernacularTitle:T 4期乳腺癌患者改良根治术后胸壁放疗加量的疗效及预后分析
- Author:
Yuchun SONG
1
;
Yanbo DENG
;
Shulian WANG
;
Yongwen SONG
;
Yu TANG
;
Yong YANG
;
Hui FANG
;
Jianyang WANG
;
Hao JING
;
Jianghu ZHANG
;
Guangyi SUN
;
Siye CHEN
;
Xuran ZHAO
;
Jing JIN
;
Yueping LIU
;
Bo CHEN
;
Shunan QI
;
Ning LI
;
Yuan TANG
;
Ningning LU
;
Yexiong LI
Author Information
1. 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科 100021
- From:
Chinese Journal of Radiation Oncology
2020;29(5):342-348
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the efficacy of chest wall boost radiotherapy in stage T 4 breast cancer patients after modified radical mastectomy. Methods:A retrospective analysis was performed on the data of 148 stage T 4 breast cancer patients who were admitted from 2000 to 2016 and received radiotherapy after modified radical mastectomy. There were 57 cases in the chest wall boost radiotherapy group and 91 cases in the conventional dose group. Radiotherapy was performed by conventional+ chest wall electron beam, three-dimensional conformal+ chest wall electron beam, intensity modulated radiotherapy+ chest wall electron beam irradiation. EQD 2 at the boost group was >50Gy. All patients received neoadjuvant chemotherapy. Kaplan-Meier method was used to analyze survival; Logrank was used to test differences; and Cox model was used to do multivariate prognostic analysis. Results:The median follow-up time was 67.2 months. The 5-year rates of chest wall recurrence (CWR), locoregional recurrence (LRR), disease-free survival (DFS), and overall survival (OS) were 9.9%, 16.2%, 58.0%, and 71.4%, respectively. The 5-year rates of CWR, LRR, DFS, and OS with and without chest wall boost radiotherapy were 14% vs. 7%, 18% vs. 15%, 57% vs. 58%, 82% vs. 65%( P>0.05), respectively. Multivariate analysis showed that chest wall boost radiotherapy had no significant effect on prognosis ( P>0.05). Among 45 patients in the recurrent high-risk group, boost radiotherapy seemed to have higher OS rate ( P=0.058), DFS rate ( P=0.084), and lower LRR rate ( P=0.059). Conclusions:Stage T 4 breast cancer patients had strong heterogeneity. Chest wall boost radiotherapy did not apparently benefit all patients. For patients with 2-3 high risk factors including positive vascular tumor embolus, pN 2-N 3, and hormone receptor negative, chest wall boost radiotherapy showed a trend of improving efficacy.
