계명대학교 의학도서관 Repository

Role of Elective Nodal Irradiation in Patients With ypN0 After Neoadjuvant Chemotherapy Followed by Breast-Conserving Surgery

Metadata Downloads
Affiliated Author(s)
김진희
Alternative Author(s)
Kim, Jin Hee
Journal Title
Clinical Breast Cancer
ISSN
1938-0666
Issued Date
2019
Keyword
Breast neoplasmNeoadjuvant therapyPartial mastectomyRadiation therapySubtype
Abstract
This multi-institutional study aimed to investigate the role of elective nodal irradiation (ENI) in ypN0 patients following neoadjuvant chemotherapy and breast-conserving surgery according to subtype and primary tumor response. We analyzed 261 patients and found that ENI does not improve survival regardless of subtype or primary tumor response. Whole-breast irradiation might be sufficient in ypN0 patients.

Background:
Given the lack of established indications for elective nodal irradiation (ENI) in ypN0 patients after neoadjuvant chemotherapy (NAC) and breast-conserving surgery (BCS), we set out to investigate the role of ENI in ypN0 patients according to subtype and pathologic complete remission (pCR) status.

Patients and Methods:
We analyzed 261 patients who received NAC followed by BCS and adjuvant radiotherapy in 13 institutions of the Korean Radiation Oncology Group from 2005 to 2011. The tumors were classified into one of 3 subtypes: luminal (estrogen receptor positive or progesterone receptor positive and HER2 negative), HER2 (HER2 positive), or triple negative (estrogen receptor, progesterone receptor, and HER2 negative). We compared locoregional control (LRC), diseasefree survival (DFS), and overall survival (OS) according to ENI in different subgroups generated by the subtype and pCR statuses.

Results:
In all patients, the 5-year LRC, DFS, and OS rates were 96.0%, 91.0%, and 96.8%, respectively. In all patients, axillary lymph node dissection was found to be the only favorable factor for LRC (P ¼ .023)and DFS (P ¼ .001). Age 50 years (P ¼ .027), negative resection margin (P ¼ .002), and axillary lymph node dissection (P ¼ .002) were all favorable factors for OS. ENI did not affect LRC, DFS, or OS. Subgroup analysis by tumor subtype and pCR showed that ENI was not associated with greater LRC or DFS in any subgroups.

Conclusion:
In ypN0 patients after NAC and BCS, ENI did not improve LRC or survival, regardless of subtype or primary tumor response. This result should be verified through larger prospective trials.
Department
Dept. of Radiation Oncology (방사선종양학)
Publisher
School of Medicine (의과대학)
Citation
Won Kyung Cho et al. (2019). Role of Elective Nodal Irradiation in Patients With ypN0 After Neoadjuvant Chemotherapy Followed by Breast-Conserving Surgery. Clinical Breast Cancer, 19(1), 78–86. doi: 10.1016/j.clbc.2018.08.009
Type
Article
ISSN
1938-0666
DOI
10.1016/j.clbc.2018.08.009
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41891
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
공개 및 라이선스
  • 공개 구분공개
  • 엠바고Forever
파일 목록

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.