Clinical Research Papers:
Optimal radiation dose for patients with one to three lymph node positive breast cancer following breast-conserving surgery and anthracycline plus taxane-based chemotherapy: A retrospective multicenter analysis (KROG 1418)
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Abstract
Haeyoung Kim1, Won Park2, Jeong Il Yu2, Doo Ho Choi2, Seung Jae Huh2, Yeon-Joo Kim3, Eun Sook Lee3, Keun Seok Lee3, Han-Sung Kang3, In Hae Park3, Kyung Hwan Shin4, Kyubo Kim5, Kyung Ran Park5, Yong Bae Kim6, Sung Ja Ahn7, Jong Hoon Lee8, Jin Hee Kim9, Mison Chun10, Hyung-Sik Lee11, Jung Soo Kim12 and Jong-Young Lee13
1 Department of Radiation Oncology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi, South Korea
2 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
3 Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
4 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
5 Department of Radiation Oncology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
6 Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
7 Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, South Korea
8 Department of Radiation Oncology, St. Vincent’s Hospital, The Catholic University of Korea College of Medicine, Suwon, South Korea
9 Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea
10 Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Gyeonggi, South Korea
11 Department of Radiation Oncology, Dong-A University Hospital, Dong-A University School of Medicine, Busan, South Korea
12 Department of Radiation Oncology, Chonbuk National University Medical School, Jeonju, Jeollabuk, South Korea
13 Department of Radiation Oncology, Wonju Severance Christian Hospital, Wonju, Kangwon, South Korea
Correspondence to:
Won Park, email:
Keywords: breast neoplasms, radiotherapy, dose-response relationship, prognosis
Received: May 17, 2016 Accepted: August 25, 2016 Published: October 25, 2016
Abstract
Background and Purpose: This study was performed to determine optimal radiation dose in pN1 breast cancer patients who received breast conserving surgery (BCS) and anthracycline plus taxane (AT)-based chemotherapy.
Materials and Methods: Retrospective chart reviews were performed in 1,147 patients who were treated between January 2006 and December 2010. The impact of radiation dose on treatment outcomes was evaluated.
Results: Median follow-up time was 66 months. The 5-year rate of disease-free survival (DFS) was 93.2%. Larger tumor size (> 20 mm), positive lymphovascular invasion, high histologic grade, and high ratio of positive nodes (> 0.1) were significantly associated with inferior DFS. By using the 4 factors related to DFS, patients were categorized into high-risk (with ≥ 3 factors) and low-risk (with < 3 factors) groups. In the high-risk group, higher radiation dose (> 60.3 GyEQD2) was significantly associated with better DFS than the lower dose (≤ 60.3 GyEQD2). However, the radiation dose did not impact DFS in the low-risk group.
Conclusions: Dosing of radiation affects the outcome of post-BCS radiotherapy in pN1 breast cancer. Doses of over 60.3 GyEQD2 were associated with better outcome in the high-risk patients.
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