Changes in postmastectomy radiotherapy targets among breast cancer patients in China from 1999 to 2008:an epidemiological study
WANG Shu-lian,LI Ye-xiong, SONG Qing-kun, LI Jing, FAN Jin-hu, ZHANG Bin, YANG Hong-jian, XIE Xiao-ming, TANG ZHong-hua, LI Hui, LI Jia-yuan, HE Jian-jun, QIAO You-lin.
Departmentof Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Pecking Union Medical College, Beijing 100021, China
Objective To investigate the changes in postmastectomy radiotherapy (PMRT) targets among breast cancer patients in China. Methods A multi-center retrospective epidemiological study was undertaken. Breast cancer patients who had received PMRT from 1999 to 2008 were randomly selected from seven hospitals in China, and the information on radiation targets, including the chest wall (CW), supraclavicular and infraclavicular regions (SCR/ICR), axilla, and internal mammary chain (IMC) was collected and analyzed. The Cochran-Armitage trend test and chi-square test were performed using SAS software to analyze the variation of PMRT targets over time, the differences in PMRT targets between hospitals, and the relationship between PMRT targets and clinicopathologic characteristics. Results Of 661 included patients, 596(90.2%), 606(91.5%), 196(29.6%), and 297(44.9%) had received PMRT to the CW, SCR/ICR, axilla, and IMC, respectively. From 1999 to 2008, there were an increase in use of PMRT to the CW (P=0.000) and decreases in use of PMRT to the axilla (P=0.027) and IMC (P=0.000). There were significant differences in use of PMRT to the CW (P=0.008), axilla (P=0.000), IMC (P=0.000),and SCR/ICR (P=0.000) between hospitals, but there were no significant differences in use of PMRT to the SCR/ICR from 1999 to 2008(P=0.597). Use of PMRT to the axilla was associated with positive axillary nodes (P=0.007) and an axillary nodal ratio of 20% or more (P=0.007). Use of PMRT to the IMC was more frequent in patients with tumor located in the inner quadrant (P=0.015). Conclusions From 1999 to 2008, PMRT targets among breast cancer patients varied greatly over time and between different hospitals in China;most patients received PMRT to the CW and SCR/ICR, and use of PMRT to the axilla and IMC decreased significantly.
WANG Shu-lian,LI Ye-xiong,SONG Qing-kun et al. Changes in postmastectomy radiotherapy targets among breast cancer patients in China from 1999 to 2008:an epidemiological study[J]. Chinese Journal of Radiation Oncology, 2013, 22(5): 347-350.
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