Postmastectomy Radiation Improves the Outcome of Patients With Locally Advanced Breast Cancer Who Achieve a Pathologic Complete Response to Neoadjuvant Chemotherapy

Journal Article · Sun Jul 15 04:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.01.023· OSTI ID:20953548

McGuire, Sean E ^[1]; Gonzalez-Angulo, Ana M ^[2]; Huang, Eugene H ^[1]; Tucker, Susan L ^[3]; Kau, S -W.C. ^[2]; Yu, T -K ^[1]; Strom, Eric A ^[1]; Oh, Julia L ^[1]; Woodward, Wendy A ^[1]; Tereffe, Welela ^[1]; Hunt, Kelly K; Kuerer, Henry M ^[4]; Sahin, Aysegul A ^[5]; Hortobagyi, Gabriel N ^[2]; Buchholz, Thomas A ^[1]

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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 Biostatistics and Applied Mathematics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
4. Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
5. Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

Purpose: The aim of this study was to investigate the role of postmastectomy radiation therapy in women with breast cancer who achieved a pathologic complete response (pCR) to neoadjuvant chemotherapy. Methods and Materials: We retrospectively identified 226 patients treated at our institution who achieved a pCR at surgery after receiving neoadjuvant chemotherapy. Of these, the 106 patients without inflammatory breast cancer who were treated with mastectomy were analyzed. The patients' clinical stages at diagnosis were I in 2%, II in 31%, IIIA in 30%, IIIB in 25%, and IIIC in 11% (American Joint Committee on Cancer 2003 system). Of the patients, 92% received anthracycline-based chemotherapy, and 38% also received a taxane. A total of 72 patients received postmastectomy radiation therapy, and 34 did not. The actuarial rates of local-regional recurrence (LRR) and survival of the two groups were compared using the log-rank test. Results: The median follow-up of surviving patients was 62 months. Use of radiation therapy did not affect the 10-year rates of LRR for patients with Stage I or II disease (the 10-year LRR rates were 0% for both groups). However, the 10-year LRR rate for patients with Stage III disease was significantly improved with radiation therapy (7.3% {+-} 3.5% with vs. 33.3% {+-} 15.7% without; p 0.040). Within this cohort, use of radiation therapy was also associated with improved disease-specific and overall survival. Conclusion: Postmastectomy radiation therapy provides a significant clinical benefit for breast cancer patients who present with clinical Stage III disease and achieve a pCR after neoadjuvant chemothearpy.

• OSTI ID: 20953548
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 68; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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RADIOTHERAPY
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