Postmastectomy Radiotherapy in Patients with pT1-2N1 Breast Cancer Treated with Taxane-Based Chemotherapy: A Retrospective Multicenter Analysis (KROG 1418)

Cancer Res Treat. 2017 Oct;49(4):927-936. doi: 10.4143/crt.2016.508. Epub 2016 Dec 26.

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.

Keywords: Breast neoplasms; Disease-free survival; Radiotherapy; Recurrence; Survival; Taxane.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Breast Neoplasms / therapy*
  • Bridged-Ring Compounds / administration & dosage
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Female
  • Humans
  • Lymphatic Metastasis
  • Mastectomy
  • Middle Aged
  • Neoplasm Staging
  • Postoperative Care*
  • Radiotherapy, Adjuvant
  • Recurrence
  • Retrospective Studies
  • Survival Analysis
  • Taxoids / administration & dosage
  • Treatment Failure
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Bridged-Ring Compounds
  • Taxoids
  • taxane