Jyoti Mayadev1, Kari Fish2, Richard Valicenti3, Dee West2, Allen Chen4, Steven Martinez5, Theodore Phillips6. 1. Department of Radiation Oncology, University of California Davis Medical Center, Sacramento, California. Electronic address: jyoti.mayadev@ucdmc.ucdavis.edu. 2. Biostatistics and Epidemiology, California Cancer Registry, Sacramento, California. 3. Department of Radiation Oncology, University of California Davis Medical Center, Sacramento, California. 4. Department of Radiation Oncology, University of California Los Angeles Medical Center, Los Angeles, California. 5. Department of Surgical Oncology, University of California Davis Medical Center, Sacramento, California. 6. Department of Radiation Oncology, University of California San Francisco Medical Center, San Francisco, California.
Abstract
PURPOSE: Additional radiation following postmastectomy radiation (PMRT) has an undefined benefit. We investigate those likely to be selected for a chest wall boost (CWB) and its effect on breast cancer survival (BCS) and overall survival (OS). METHODS AND MATERIALS: A total of 4747 women diagnosed from 2005 to 2009 were treated with PMRT identified from the California Cancer Registry (CCR); 2686 (57%) received a CWB. Univariate and multivariate analyses compared those receiving and not receiving a CWB for BCS and OS. RESULTS: With a median follow-up of 43.6 months, patients likely to receive a CWB were stage III (P ≤ .001), grade 3/4 (P = .03), positive nodes (P = .04), HER 2+ (P =.02). CWB was not related to BCS in the univariate (hazard ratio [HR], 1.00; 95% confidence interval [CI], 0.82-1.21), multivariate (HR, 1.04; 95% CI, 0.86 -1.26) analyses, and was not related OS for the univariate (HR, 0.92; 95% CI, 0.78-1.10), multivariate (HR, 0.95; 95% CI, 0.80-1.13) analyses. However, in multivariate analysis, patients not receiving chemotherapy who had a CWB had better BCS (HR, 1.77; 95% CI, 1.11-2.83). CONCLUSIONS: The majority of patients were treated with a CWB. We found no difference in BCS or OS with the addition of a CWB.
PURPOSE: Additional radiation following postmastectomy radiation (PMRT) has an undefined benefit. We investigate those likely to be selected for a chest wall boost (CWB) and its effect on breast cancer survival (BCS) and overall survival (OS). METHODS AND MATERIALS: A total of 4747 women diagnosed from 2005 to 2009 were treated with PMRT identified from the California Cancer Registry (CCR); 2686 (57%) received a CWB. Univariate and multivariate analyses compared those receiving and not receiving a CWB for BCS and OS. RESULTS: With a median follow-up of 43.6 months, patients likely to receive a CWB were stage III (P ≤ .001), grade 3/4 (P = .03), positive nodes (P = .04), HER 2+ (P =.02). CWB was not related to BCS in the univariate (hazard ratio [HR], 1.00; 95% confidence interval [CI], 0.82-1.21), multivariate (HR, 1.04; 95% CI, 0.86 -1.26) analyses, and was not related OS for the univariate (HR, 0.92; 95% CI, 0.78-1.10), multivariate (HR, 0.95; 95% CI, 0.80-1.13) analyses. However, in multivariate analysis, patients not receiving chemotherapy who had a CWB had better BCS (HR, 1.77; 95% CI, 1.11-2.83). CONCLUSIONS: The majority of patients were treated with a CWB. We found no difference in BCS or OS with the addition of a CWB.
Authors: Kamran A Ahmed; Casey L Liveringhouse; Matthew N Mills; Nicholas B Figura; G Daniel Grass; Iman R Washington; Eleanor E Harris; Brian J Czerniecki; Peter W Blumencranz; Steven A Eschrich; Jacob G Scott; Roberto Diaz; Javier F Torres-Roca Journal: EBioMedicine Date: 2019-08-12 Impact factor: 11.205