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Abstract

PURPOSE:

The purpose of this study was to evaluate the impact of postmastectomy radiotherapy (PMRT) on loco-regional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) in pT1-2N1 patients treated with taxane-based chemotherapy.

MATERIALS AND METHODS:

We retrospectively reviewed the medical data of pathological N1 patients who were treated with modified radical mastectomy and adjuvant taxane-based chemotherapy in 12 hospitals between January 2006 and December 2010.

RESULTS:

We identified 714 consecutive patients. The median follow-up duration was 69 months (range, 1 to 114 months) and the 5-year LRRFS, DFS, and OS rates were 97%, 94%, and 98%, respectively, in patients who received PMRT (PMRT [+]). The corresponding figures were 96%, 90%, and 96%, respectively, in patients who did not receive PMRT (PMRT [-]). PMRT had no significant impact on survival. Upon multivariable analysis, only the histological grade (HG) was statistically significant as a prognostic factor for LRRFS and DFS. In a subgroup analysis of HG 3 patients, PMRT (+) showed better DFS (p=0.081).

CONCLUSION:

PMRT had no significant impact on LRRFS, DFS, or OS in pT1-2N1 patients treated with taxane-based chemotherapy. PMRT showed a marginal benefit for DFS in HG 3 patients. Randomized studies are needed to confirm the benefit of PMRT in high risk patients, such as those with HG 3.

Author information

Kim YJ1, Park W2, Ha B1, Park B3, Joo J3, Kim TH1, Park IH1, Lee KS1, Lee ES1, Shin KH4, Kim H5, Yu JI2, Choi DH2, Huh SJ2, Wee CW4, Kim K6, Park KR6, Kim YB7, Ahn SJ8, Lee JH9, Kim JH10, Chun M11, Lee HS12, Kim JS13, Cha J14.

1 Research Institute and Hospital, National Cancer Center, Goyang, Korea.

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

3 Biometric Research Branch, National Cancer Center, Goyang, Korea.

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

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

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

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

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

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

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

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

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

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

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