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KMID : 0939920170490040970
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대한암학회지
2017 Volume.49 No. 4 p.970 ~ p.980
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Prognostic Impact of Elective Supraclavicular Nodal Irradiation for Patients with N1 Breast Cancer after Lumpectomy and Anthracycline Plus Taxane-Based Chemotherapy (KROG 1418): A Multicenter Case-Controlled Study
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Kim Hae-Young
Park Won
Yu Jeong-Il
Choi Doo-Ho
Huh Seung-Jae
Kim Yeon-Joo
Lee Eun-Sook
Lee Keun-Seok
Kang Han-Sung
Park In-Hae
Shin Kyung-Hwan
Wee Chan-Woo
Kim Kyu-Bo
Park Kyung-Ran
Kim Yong-Bae
Ahn Sung-Ja
Lee Jong-Hoon
Kim Jin-Hee
Chun Mi-Son
Lee Hyung-Sik
Kim Jung-Soo
Cha Ji-Hye
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Abstract
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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.
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KEYWORD
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Breast neoplasms, Adjuvant radiotherapy, Lymphatic irradiation, Taxane, Case-control studies
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