乳腺癌保乳术后1~3个腋窝淋巴结阳性者锁骨上淋巴结复发风险分析

doi:10.3760/cma.j.issn.1004-4221.2015.02.000

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Abstract Objective To evaluate the supraclavicular nodal failure (SCF) of the breast cancer patients with one to three positive axillary nodes treated with breast conserving surgery and to identify the risk factors for SCF. Methods From Jan. 2001 to Mar. 2014, 256 breast cancer patients with one to three positive axillary nodes treated with breast conserving surgery and axillary dissection were analyzed. All patients received whole breast radiation to a total dose of 46－50 Gy (median 50 Gy) at 2 Gy/f or 43.5 Gy at 2.9 Gy/f. Tumor bed was boosted to 50－70 Gy (median 60 Gy) at 2 Gy/f or 52.2 Gy at 2.9 Gy/f. No patient received regional nodal radiation. 245(95.7%) patients received adjuvant chemotherapy. The SCF, LRR, DM and OS rates were calculated by Kaplan-Meier method and compare by the Logrank test. Results The number of samples were 101 followed up at 5 years. The 5-year SCF, LRR, DM and OS rates were 2.1%, 2.1%, 5%, 98%, respectively. LVI and 2 to 3 positive axillary node and Luminal B were risk factors for SCF (P=0.030,0.010,0.006). The 5-year SCF rate were 5.3% for patients with 2－3 positive axillary nodes and 2.8% for those with 1 positive nodes (P=0.010);5.3% and 1.8% for those LVI positive and negative (P=0.030);7.1%, 3.2%, 1.2% and 0% for Luminal B, Basal, Luminal A and Her-2 positive type (P=0.006). Patients with 0, 1 and2-3 risk factors had 5 year SCF rates of 0%, 3.0% and 10.6%(P=0.000). Conclusions The supraclavicular nodal recurrence rate is very low for breast cancer patients with one to three positive axillary nodes treated with breast conserving surgery without supraclavicular nodal radiation, indicating that prophylactive supraclavicular nodal is not necessary. Further research is needed to verify whether those patients with risk factors need SCF radiation or not.

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	Articles by authors
	Li Shuai
	Wang Shulian
	Li Yexiong
	Song Yongwen
	Wang Weihu
	Jin Jing
	Liu Yueping
	Fang Hui
	Ren Hua
	Liu Xinfan
	Yu Zihao

Key words： Breast neoplasm/postoperative radiotherapy Breast neoplasm/breast conserving surgery Supraclavicular nodal failure

Received: 13 December 2014

Corresponding Authors: Li Yexiong, Email:yexiong12@163.com;Wang Shulian,Email:wsl20040118@yahoo.com

Cite this article:

Li Shuai,Wang Shulian,Li Yexiong et al. Risk factors for supraclavicular nodal failure in breast cancer patients with one to three positive axillary nodes treated with breast conserving surgery[J]. Chinese Journal of Radiation Oncology, 2015, 24(2): 149-153.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2015.02.000 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2015/V24/I2/149

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