바로가기  >

Abstract

PURPOSE:

This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy.

MATERIALS AND METHODS:

We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups.

RESULTS:

​A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI.

CONCLUSION:

We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.

Author information​

Kim H1, Park W2, Yu JI2, Choi DH2, Huh SJ2, Kim YJ3, Lee ES3, Lee KS3, Kang HS3, Park IH3, Shin KH4, Wee CW4, Kim K5, Park KR5, Kim YB6, Ahn SJ7, Lee JH8, Kim JH9, Chun M10, Lee HS11, Kim JS12, Cha J13.

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

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

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

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

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

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

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

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

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

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

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

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

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