Oncotarget

Research Papers:

Impact of postmastectomy radiation therapy in T1-2 breast cancer patients with 1-3 positive axillary lymph nodes

Hang Yin, Yuanyuan Qu, Xiaoyuan Wang, Tengchuang Ma, Haiyang Zhang, Yu Zhang, Yang Li, Siliang Zhang, Hongyu Ma, Enkang Xing, Xueying Liu and Qingyong Xu _

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Oncotarget. 2017; 8:49564-49573. https://doi.org/10.18632/oncotarget.17318

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Abstract

Hang Yin1,*, Yuanyuan Qu1,*, Xiaoyuan Wang2,*, Tengchuang Ma3, Haiyang Zhang4, Yu Zhang1, Yang Li1, Siliang Zhang1, Hongyu Ma1, Enkang Xing1, Xueying Liu1 and Qingyong Xu1

1The Department of Breast Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China

2The Department of Internal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China

3The Department of Nuclear Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China

4The Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China

*These authors have contributed equally to this work

Correspondence to:

Qingyong Xu, email: xuqingyonghmu@163.com

Keywords: breast neoplasms, surgery, radiotherapy, prognosis, locoregional recurrence

Received: October 20, 2016    Accepted: March 31, 2017    Published: April 21, 2017

ABSTRACT

The effect of postmastectomy radiotherapy (PMRT) on T1-2 breast cancer patients with 1-3 positive axillary lymph nodes is controversial up to now. The purpose of this study was to evaluate the impact of postmastectomy radiotherapy for these patients. The prognostic factor effecting locoregional free-survival (LRFS) was also analyzed. In the retrospective clinical data of 1674 eligible patients, survival analysis was performed using the method of Kaplan-Meier and the log-rank test. Cox regression analysis was applied to identify the significant prognostic factors. We found PMRT increased 5-year LRFS (p=0.003), but could not improve 5-year disease-free survival or overall survival statistically. For patients without PMRT, multivariate analysis revealed that age, lymph node ratio and molecule subtype were risk factors effecting LRFS. To further analyze the role of PMRT, we grouped all the patients into low risk group (0 or 1 risk factor) and high risk group (2 or 3 risk factors) depending on these risk factors. We found that in low-risk group, PMRT increased only 5-year LRFS (p=0.012). However, in high-risk group, PMRT increased both 5-year LRFS (p=0.005) and 5-year disease-free survival (p=0.033), but could not improve 5-year overall survival statistically. Thus, these data provide the evidence that PMRT could improve LRFS for T1-2 breast cancer patients with 1-3 positive axillary lymph nodes. Additionally, PMRT could improve LRFS and disease-free survival for high risk patients. Age, lymph node ratio and molecule subtype were high risk factors effecting LRFS in our study.


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