방사선의학 웹진

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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.​ 

Author information

Kim H1, Park W2, Yu JI2, Choi DH2, Huh SJ2, Kim YJ3, Lee ES3, Lee KS3, Kang HS3, Park IH3, Shin KH4, Kim K5, Park KR5, Kim YB6, Ahn SJ7, Lee JH8, Kim JH9, Chun M10, Lee HS11, Kim JS12, Lee JY13.

1Department of Radiation Oncology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi, South Korea.

2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

3Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, South Korea.

4Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea.

5Department of Radiation Oncology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea.

6Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.

7Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, South Korea.

8Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, South Korea.

9Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea.

10Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Gyeonggi, South Korea.

11Department of Radiation Oncology, Dong-A University Hospital, Dong-A University School of Medicine, Busan, South Korea.

12Department of Radiation Oncology, Chonbuk National University Medical School, Jeonju, Jeollabuk, South Korea.

13Department of Radiation Oncology, Wonju Severance Christian Hospital, Wonju, Kangwon, South Korea.