Oncological outcomes in patients with residual triple-negative breast cancer after preoperative chemotherapy

• 발행기관: 대한방사선종양학회
• 저자명: Hyunki Park Haeyoung Kim Won Park Won Kyung Cho Nalee Kim Tae Gyu Kim Young-Hyuck Im Jin Seok Ahn Yeon Hee Park Ji-Yeon Kim Seok Jin Nam Seok Won Kim Jeong Eon Lee Jonghan Yu Byung Joo Chae Sei Kyung Lee Jai-Min Ryu
• 간행물 정보: 『대한방사선종양학회지』제42권 제3호, 210~217쪽, 전체 8쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2024.09.30

국문 초록

Purpose: This study aimed to evaluate the clinical outcomes and prognostic implications of regional nodal irradiation (RNI) after neoadjuvant chemotherapy (NAC) in patients with residual triple-negative breast cancer (TNBC). Materials and Methods: We analyzed 152 patients with residual TNBC who underwent breast-conserving surgery after NAC between December 2008 and December 2017. Most patients (n = 133; 87.5%) received taxane-based chemotherapy. Adjuvant radiotherapy (RT) was administered at a total dose of 45–65 Gy in 15–30 fractions to the whole breast, with some patients also receiving RT to regional nodes. Survival was calculated using the Kaplan–Meier method, and prognostic factors influencing survival were analyzed using the Cox proportional-hazards model. Results: During a median follow-up of 66 months (range, 9 to 179 months), the 5-year disease-free survival (DFS) rate was 68.0%. The 5-year locoregional recurrence-free survival, distant metastasis-free survival, and overall survival rates were 83.6%, 72.6%, and 78.7%, respectively. In the univariate analysis, the cN stage, ypT stage, ypN stage, axillary operation type, and RT field were associated with DFS. Multivariate analysis revealed that higher ypT stage (hazard ratio [HR] = 2.0; 95% confidence interval [CI] 1.00–3.82; p = 0.049) and ypN stage (HR = 4.7; 95% CI 1.57–14.24; p = 0.006) were associated with inferior DFS. Among clinically node-positive patients, those who received RT to the breast only had a 5-year DFS of 73.7%, whereas those who received RNI achieved a DFS of 59.6% (p = 0.164). There were no differences between the DFS and RNI. Conclusion: In patients with residual TNBC, higher ypT and ypN stages were associated with poorer outcomes after NAC. RNI did not appear to improve DFS. More intensive treatments incorporating systemic therapy and RT should be considered for these patients.

목차

Introduction

Materials and Methods

Results

Discussion and Conclusion

Statement of Ethics

Conflict of Interest

Funding

Author Contributions

Data Availability Statement

References

키워드

Triple negative breast neoplasms Neoadjuvant chemotherapy Pathologic complete response Treatment outcome Lymphatic irradiations