Article ID Journal Published Year Pages File Type
5529983 Radiotherapy and Oncology 2017 5 Pages PDF
Abstract

Background and purposeWe evaluated the effect of post-mastectomy radiation (PMRT) in 1-3 positive lymph nodes (LN) in patients who received uniform modern systemic therapy.Materials and methodsCohort study using individual data collected for 1,649 node-positive women who received doxorubicin/cyclophosphamide with sequential docetaxel in 2000-2003 on the control arm of BCIRG-005. All women underwent mastectomy or lumpectomy and axillary LN dissection. PMRT was given at investigator's discretion.ResultsA total of 523 women with 1-3 positive LN underwent mastectomy and 39% (206/523) received PMRT. With a median follow-up of 10 years, PMRT improved loco-regional control (LRC) from 91% to 98% (p = 0.001) but had no effect on overall survival (OS) (84% vs. 86%, p = 0.9). On multivariate analysis, PMRT improved local control (LC) (hazard ratio, 0.14; 95% CI, 0.03-0.62; p = 0.01) and LRC (hazard ratio, 0.15; 95% CI, 0.04-0.50; p = 0.002). PMRT did not significantly impact OS on multivariate analysis (hazard ratio, 0.91; 95% CI, 0.55-1.51; p = 0.7). Results remained consistent with the use of propensity score analysis.ConclusionsIn this cohort of patients with N1 disease treated with modern systemic therapy, PMRT improves LRC but has no effect on OS. The rates of OS were excellent, irrespective of adjuvant radiation.

Related Topics
Life Sciences Biochemistry, Genetics and Molecular Biology Cancer Research
Authors
, , , ,