The Benefit of Post-Mastectomy Radiotherapy in ypN0 Patients after Neoadjuvant Chemotherapy According to Molecular Subtypes

被引：13

作者：

Cho, Won Kyung ^{[1
]}

Park, Won ^{[1
]}

Choi, Doo Ho ^{[1
]}

Kim, Yong Bae ^{[2
]}

Kim, Jin Ho ^{[3
]}

Kim, Su Ssan ^{[4
]}

Kim, Kyubo ^{[5
]}

Kim, Jin Hee ^{[6
]}

Ahn, Sung-Ja ^{[7
]}

Lee, Sun Young ^{[8
]}

Lee, Jeongshim ^{[9
]}

Kim, Sang-Won ^{[10
,11
]}

Kwon, Jeanny ^{[12
]}

Ahn, Ki Jung ^{[13
]}

机构：

[1] Sungkyunkwan Univ, Sch Med, Dept Radiat Oncol, Samsung Med Ctr, 81 Irwon Ro, Seoul 06351, South Korea

[2] Yonsei Univ, Coll Med, Yonsei Canc Ctr, Dept Radiat Oncol, Seoul, South Korea

[3] Seoul Natl Univ, Coll Med, Dept Radiat Oncol, Seoul, South Korea

[4] Univ Ulsan, Asan Med Ctr, Dept Radiat Oncol, Coll Med, Seoul, South Korea

[5] Ewha Womans Univ, Dept Radiat Oncol, Sch Med, Seoul, South Korea

[6] Keimyung Univ, Sch Med, Dongsan Med Ctr, Dept Radiat Oncol, Daegu, South Korea

[7] Chonnam Natl Univ, Dept Radiat Oncol, Med Sch, Gwangju, South Korea

[8] Chonbuk Natl Univ, Dept Radiat Oncol, Med Sch, Jeonju, South Korea

[9] Inha Univ Hosp, Dept Radiat Oncol, Incheon, South Korea

[10] Ajou Univ, Dept Radiat Oncol, Sch Med, Suwon, South Korea

[11] Konyang Univ, Coll Med, Dept Radiat Oncol, Daejeon, South Korea

[12] Chungnam Natl Univ, Dept Radiat Oncol, Coll Med, Daejeon, South Korea

[13] Inje Univ, Busan Paik Hosp, Dept Radiat Oncol, Busan, South Korea

来源：

JOURNAL OF BREAST CANCER | 2019年 / 22卷 / 02期

关键词：

Breast neoplasms; Mastectomy; Neoadjuvant treatment; Radiotherapy; BREAST-CANCER PATIENTS; LOCOREGIONAL RECURRENCE; RADIATION-THERAPY; MASTECTOMY; RECEPTOR; RISK;

D O I：

10.4048/jbc.2019.22.e25

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: The benefit of post-mastectomy radiation therapy (PMRT) in patients with breast cancer who achieve ypN0 following neoadjuvant chemotherapy (NAC) has not yet been established. This study aimed to identify the role of PMRT in patients who achieve ypN0 according to molecular subtype. Methods: We identified patients initially suspected with axillary disease who achieved ypN0 following NAC. From 13 institutions of the Korean Radiation Oncology Group between 2005 and 2011, a total of 189 patients were included in the analysis. Effects of PMRT on loco-regional control (LRC), disease-free survival (DFS), and overall survival (OS) were evaluated for different molecular subtypes. Results: In all patients, the prognostic effect of PMRT on LRC, DFS, or OS was not significant. Subgroups analysis showed that the effect of PMRT on LRC was different according to molecular subtype (p for interaction = 0.019). PMRT was associated with greater LRC in the luminal subtype (p = 0.046), but not in other subtypes. Conclusion: In patients who achieve ypN0 following NAC and mastectomy, PMRT shows no additional survival benefits for any molecular subtype.

引用

页码：285 / 296

页数：12

共 23 条

[1] PATTERNS AND RISK FACTORS OF LOCOREGIONAL RECURRENCE IN T1-T2 NODE NEGATIVE BREAST CANCER PATIENTS TREATED WITH MASTECTOMY: IMPLICATIONS FOR POSTMASTECTOMY RADIOTHERAPY [J].

Abi-Raad, Rita ;

Boutrus, Rimoun ;

Wang, Rui ;

Niemierko, Andrzej ;

Smith, Barbara ;

Taghian, Alphonse G. .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2011, 81 (03) :E151-E157

[2] Lymphovascular invasion after neoadjuvant chemotherapy is strongly associated with poor prognosis in breast carcinoma [J].

Hamy, Anne-Sophie ;

Giang-Thanh Lam ;

Laas, Enora ;

Darrigues, Lauren ;

Balezeau, Thomas ;

Guerin, Julien ;

Livartowski, Alain ;

Sadacca, Benjamin ;

Pierga, Jean-Yves ;

Vincent-Salomon, Anne ;

Coussy, Florence ;

Becette, Veronique ;

Bonsang-Kitzis, Helene ;

Rouzier, Roman ;

Feron, Jean-Guillaume ;

Benchimol, Gabriel ;

Lae, Marick ;

Reyal, Fabien .

BREAST CANCER RESEARCH AND TREATMENT, 2018, 169 (02) :295-304

[3] Locoregional recurrence rates and prognostic factors for failure in node-negative patients treated with mastectomy: Implications for postmastectomy radiation [J].

Jagsi, R ;

Raad, RA ;

Goldberg, S ;

Sullivan, T ;

Michaelson, J ;

Powell, SN ;

Taghian, AG .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2005, 62 (04) :1035-1039

[4] Post-mastectomy radiation therapy and overall survival after neoadjuvant chemotherapy [J].

Kantor, Olga ;

Pesce, Catherine ;

Singh, Puneet ;

Miller, Megan ;

Tseng, Jennifer ;

Wang, Chi-Hsiung ;

Winchester, David J. ;

Yao, Katharine .

JOURNAL OF SURGICAL ONCOLOGY, 2017, 115 (06) :668-676

[5] Estrogen receptor, progesterone receptor, HER-2, and response to postmastectomy radiotherapy in high-risk breast cancer: The Danish Breast Cancer Cooperative Group [J].

Kyndi, Marianne ;

Sorensen, Flemming B. ;

Knudsen, Helle ;

Overgaard, Marie ;

Nielsen, Hanne Melgaard ;

Overgaard, Jens .

JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (09) :1419-1426

[6] Intrinsic subtypes and benefit from postmastectomy radiotherapy in node-positive premenopausal breast cancer patients who received adjuvant chemotherapy - results from two independent randomized trials [J].

Laurberg, Tinne ;

Tramm, Trine ;

Nielsen, Torsten ;

Alsner, Jan ;

Nord, Silje ;

Myhre, Simen ;

Sorlie, Therese ;

Leung, Samuel ;

Fan, Cheng ;

Perou, Charles ;

Gelmon, Karen ;

Overgaard, Jens ;

Voduc, David ;

Prat, Aleix ;

Cheang, Maggie Chon U. .

ACTA ONCOLOGICA, 2018, 57 (01) :38-43

[7] Radiotherapy for stage II and stage III breast cancer patients with negative lymph nodes after preoperative chemotherapy and mastectomy [J].

Le Scodan, Romuald ;

Selz, Jessica ;

Stevens, Denise ;

Bollet, Marc A. ;

De La Lande, Brigitte ;

Daveau, Caroline ;

Lerebours, Florence ;

Labib, Alain ;

Bruant, Sarah .

International Journal of Radiation Oncology Biology Physics, 2012, 82 (01) :e1

[8] The role of postmastectomy radiotherapy in clinically node-positive, stage II-III breast cancer patients with pathological negative nodes after neoadjuvant chemotherapy: an analysis from the NCDB [J].

Liu, Jieqiong ;

Mao, Kai ;

Jiang, Shuai ;

Jiang, Wen ;

Chen, Kai ;

Kim, Betty Y. S. ;

Liu, Qiang ;

Jacobs, Lisa K. .

ONCOTARGET, 2016, 7 (17) :24848-24859

[9] Lymphovascular invasion is an independent predictor of survival in breast cancer after neoadjuvant chemotherapy [J].

Liu, Ying L. ;

Saraf, Anurag ;

Lee, Shing M. ;

Zhong, Xiaobo ;

Hibshoosh, Hanina ;

Kalinsky, Kevin ;

Connolly, Eileen P. .

BREAST CANCER RESEARCH AND TREATMENT, 2016, 157 (03) :555-564

[10]

Mak Kimberley S., 2015, Journal of the National Cancer Institute Monographs, P87, DOI 10.1093/jncimonographs/lgv003

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