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Radiotherapy following modified radical mastectomy significantly improves locoregional control in patients with Rec-/HER-2+ locally advanced breast cancer
AbstractObjective To evaluate the risk of locoregional recurrence (LRR) and role of radiotherapy for patients with estrogen receptor-negative and human epidermal growth factor receptor 2-overexpressed (Rec-/HER-2+) locally advanced breast cancer (LABC). Methods A retrospective analysis was performed on the clinical data of 294 patients with Rec-/HER-2+ LABC from 1999 to 2011. All patients were treated with modified radical mastectomy (MRM). Of them, 239 patients received postmastectomy radiotherapy and 55 patients did not. Locoregional recurrence-free survival (LRRFS) and overall survival (OS), as well as LRR, were compared between the two groups. The Kaplan-Meier method was used to estimate survival and recurrence rates, and the log-rank test was used for survival difference analysis and univariate prognostic analysis. Multivariate prognostic analysis was performed using the Cox regression model. Results The 5-year sample size was 162. Fifty-six patients developed LRR. The 5-year LRRFS and OS rates were 79.7% and 70.0%, respectively. Postmastectomy radiotherapy significantly increased the 5-year LRRFS rate (85.1% vs. 56.0%, P=0.000), but did not significantly increase the 5-year OS rate (71.3% vs. 64.2%, P=0.441). Multivariate analysis indicated that postmastectomy radiotherapy was the only independent prognostic factor associated with increased LRRFS (RR=0.303, 95%CI:0.166-0.554, P=0.000). Conclusions Patients with Rec-/HER-2+ LABC treated with MRM alone appear to be at a significantly increased risk of LRR compared with those treated with MRM followed by radiotherapy.
Zhang Jianghu,Wu Tao,Wang Shuya et al. Radiotherapy following modified radical mastectomy significantly improves locoregional control in patients with Rec-/HER-2+ locally advanced breast cancer[J]. Chinese Journal of Radiation Oncology, 2015, 24(6): 619-622.
Zhang Jianghu,Wu Tao,Wang Shuya et al. Radiotherapy following modified radical mastectomy significantly improves locoregional control in patients with Rec-/HER-2+ locally advanced breast cancer[J]. Chinese Journal of Radiation Oncology, 2015, 24(6): 619-622.
[1] Valero V,Buzdar AU,Hortobagyi GN.Locally advanced breast cancer[J].Oncologist,1996,1(1-2):8-17. [2] Perou CM,S rlie T,Eisen MB,et al. Molecular portraits of human breast tumours[J].Nature,2000,406(6797):747-752.DOI:10.1038/35021093. [3] Srlie T,Tibshirani R,Parker J,et al. Repeated observation of breast tumor subtypes in independent gene expression data sets[J].Proc Natl Acad Sci USA,2003,100(14):8418-8423.DOI:10.1073/pnas.0932692100. [4] Overgaard M,Hansen PS,Overgaard J,et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy[J].N Engl J Med,1997,337(14):949-955.DOI:10.1056/NEJM199710023371401. [5] Overgaard M,Jensen MB,Overgaard J,et al. Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen:Danish Breast Cancer Cooperative Group DBCG 82c randomised trial[J].Lancet,1999,353(9165):1641-1648.DOI:10.1016/S0140-6736(98)09201-0. [6] Ragaz J,Olivotto IA,Spinelli JJ,et al. Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy:20-year results of the British Columbia randomized trial[J].J Natl Cancer Inst,2005,97(2):116-126.DOI:10.1093/jnci/djh297. [7] Clarke M,Collins R,Darby S,et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival:an overview of the randomised trials[J].Lancet,2005,366(9503):2087-2106.DOI:10.1016/S0140-6736(05)67887-7. [8] EBCTCG (Early Breast Cancer Trialists′ Collaborative Group),McGale P,Taylor C,et al. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality:meta-analysis of individual patient data for 8135 women in 22 randomised trials[J].Lancet,2014,383(9935):2127-2135.DOI:10.1016/S0140-6736(14)60488-8. [9] Perez EA,Romond EH,Suman VJ,et al. Four-year follow-up of trastuzumab plus adjuvant chemotherapy for operable human epidermal growth factor receptor 2–positive breast cancer:joint analysis of data from NCCTG N9831 and NSABP B-31[J].J Clin Oncol,2011,29(25):3366-3373.DOI:10.1200/JCO.2011.35.0868. [10] Cheang MCU,Voduc D,Bajdik C,et al. Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype[J].Clin Cancer Res,2008,14(5):1368-1376.DOI:10.1158/1078-0432.CCR-07-1658. [11] Nguyen PL,Taghian AG,Katz MS,et al. Breast cancer subtype approximated by estrogen receptor,progesterone receptor,and HER-2 is associated with local and distant recurrence after breast-conserving therapy[J].J Clin Oncol,2008,26(14):2373-2378.DOI:10.1200/JCO.2007.14.4287. [12] Dua R,Zhang JH,Nhonthachit P,et al. EGFR over-expression and activation in high HER-2,ER negative breast cancer cell line induces trastuzumab resistance[J].Breast Cancer Res Treat,2010,122(3):685-697.DOI:10.1007/s10549-009-0592-x. [13] Wang SL,Li YX,Song YW,et al. Triple-negative or HER-2-positive status predicts higher rates of locoregional recurrence in node-positive breast cancer patients after mastectomy[J].Int J Radiat Oncol Biol Phys,2011,80(4):1095-1101.DOI:10.1016/j.ijrobp.2010.03.038. [14] Wang YH,Yin QG,Yu Q,et al. A retrospective study of breast cancer subtypes:the risk of relapse and the relations with treatments[J].Breast Cancer Res Treat,2011,130(2):489-498.DOI:10.1007/s10549-011-1709-6.