Locoregional Treatment Outcomes After Multimodality Management of Inflammatory Breast Cancer

Journal Article · Wed Oct 01 00:00:00 EDT 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.01.039· OSTI ID:21124474

Bristol, Ian J; Woodward, Wendy A; Strom, Eric A ^[1]; Cristofanilli, Massimo ^[2]; Domain, Delora ^[1]; Singletary, S Eva ^[3]; Perkins, George H; Oh, Julia L; Yu, T -K; Terrefe, Welela ^[1]; Sahin, Aysegul A ^[4]; Hunt, Kelly K ^[3]; Hortobagyi, Gabriel N ^[2]

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1. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
2. Department of Breast Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
3. Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
4. Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

Purpose: The aims of this study were to determine outcomes for patients with inflammatory breast cancer (IBC) treated with multimodality therapy, to identify factors associated with locoregional recurrence, and to determine which patients may benefit from radiation dose escalation. Methods and Materials: We retrospectively reviewed 256 consecutive patients with nonmetastatic IBC treated at our institution between 1977 and 2004. Results: The 192 patients who were able to complete the planned course of chemotherapy, mastectomy, and postmastectomy radiation had significantly better outcomes than the 64 patients who did not. The respective 5-year outcome rates were: locoregional control (84% vs. 51%), distant metastasis-free survival (47% vs. 20%), and overall survival (51% vs. 24%) (p < 0.0001 for all comparisons). Univariate factors significantly associated with locoregional control in the patients who completed plan treatment were response to neoadjuvant chemotherapy, surgical margin status, number of involved lymph nodes, and use of taxanes. Increasing the total chest-wall dose of postmastectomy radiation from 60 Gy to 66 Gy significantly improved locoregional control for patients who experienced less than a partial response to chemotherapy, patients with positive, close, or unknown margins, and patients <45 years of age. Conclusions: Patients with IBC who are able to complete treatment with chemotherapy, mastectomy, and postmastectomy radiation have a high probability of locoregional control. Escalation of postmastectomy radiation dose to 66 Gy appears to benefit patients with disease that responds poorly to chemotherapy, those with positive, close, or unknown margin status, and those <45 years of age.

• OSTI ID: 21124474
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 72, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2008.01.039; PII: S0360-3016(08)00195-8; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
INFLAMMATION
LYMPH NODES
MAMMARY GLANDS
METASTASES
PATIENTS
RADIATION DOSES
SURGERY