방사선의학 웹진

바로가기  >

Abstract
Purpose: This study investigates patterns of postmastectomy radiation therapy (PMRT) use in patients with pT1-2N1 breast cancer treated with mastectomy in Korea over 2 decades.

Materials and methods: Data from 700 patients treated at 16 institutions across three decades (1990, 2000, and 2010) were retrospectively reviewed.

Results: Overall, 10.0% of patients received PMRT, with utilization rates of 7.4%, 8.8%, and 11.1% in 1990, 2000, and 2010, respectively. The use of PMRT varied substantially among the hospitals (0%-87.5%). The two-dimensional radiotherapy was used in 1990, but the adoption of tangential beam three-dimensional conformal radiotherapy increased in subsequent decades. Axillary irradiation was performed in all patients in 1990 but was omitted in some cases starting in the 2000s (performed in 72.7% of cases in 2000, 84.1% in 2010). The inclusion of axillary levels, internal mammary nodes, and supraclavicular nodes decreased over time. The 10-year overall survival (OS) and recurrence-free survival (RFS) rates for all patients were 81.3% and 76.3%, respectively. Locoregional recurrence rates were significantly lower in the PMRT group (1.4%) compared to the no-PMRT group (8.1%, p=0.043). However, no significant differences were observed in 10-year OS, RFS, or distant metastasis-free survival rates between the two groups.

Conclusion: PMRT was performed in approximately 10% of patients with pT1-2N1 breast cancer after mastectomy, with minimal changes in utilization rates over two decades. The use and extent of regional nodal irradiation has declined over time. Further research is needed to reflect the latest patterns of practice.

Affiliations

Mi Sun Kim 1, Seung Do Ahn 2, Yong Bae Kim 3, Won Park 4, Shin-Hyung Park 5, Ik Jae Lee 6, Byung-Ock Choi 7, Juri Kim 8, Sung Ja Ahn 9, Won Sup Yoon 10, Jin-Hee Kim 11, Jong Hoon Lee 12, Donghyun Kim 13, Hye Li Park 14, Yeon-Joo Kim 15, Sun Young Lee 16, Kyung Ran Park 17
1Department of Radiation Oncology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
2Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
3Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
4Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
5Department of Radiation Oncology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
6Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
7Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
8Department of Radiation Oncology, Cheil General Hospital, Seoul, Republic of Korea.
9Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.
10Department of Radiation Oncology, Korea University College of Medicine, Seoul, Republic of Korea.
11Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
12Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.
13Department of Radiation Oncology, Pusan National University School of Medicine, Busan, Republic of Korea.
14Department of Radiation Oncology, Jeonju Jesus Hospital, Jeonju, Republic of Korea.
15Department of Radiation Oncology, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
16Department of Radiation Oncology, Jeonbuk National University Hospital, Jeonju, Republic of Korea.
17Department of Radiation Oncology, Kosin University College of Medicine, Busan, Republic of Korea.