Omar Abdel-Rahman1,2. 1. Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. omar.abdelsalam@ahs.ca. 2. Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada. omar.abdelsalam@ahs.ca.
Abstract
PURPOSE: To assess the impact of postmastectomy radiotherapy (PMRT) on overall survival and relapse-free survival among breast cancer patients with T1-T2 N1 disease who received standard adjuvant systemic therapy. METHODS: This is an individual patient data pooled analysis of 1053 breast cancer patients referred for adjuvant therapy in three clinical trials (BIG 02/98, BCIRG001, and BCIRG005). Overall survival was assessed according to whether or not patients received adjuvant radiotherapy through Kaplan-Meier analysis. Univariate and multivariate analyses of predictors of overall and relapse-free survival were conducted through Cox regression analysis. RESULTS: Locoregional relapse rates (after a median follow up of 116 months) were 5.6% among patients who received adjuvant radiotherapy vs. 6.6% among patients who did not receive adjuvant radiotherapy. Actuarial 5‑ and 10-year locoregional relapse-free survival rates were 94 and 93%, respectively, among patients who did not receive adjuvant radiotherapy versus 95 and 92% among patients who received adjuvant radiotherapy. The following factors were associated with worse overall survival in multivariate Cox regression analysis: age < 40 years (P < 0.0001), T2 stage (P = 0.004), higher lymph node ratio (P < 0.0001), and negative hormone receptor status (P < 0.0001). Likewise, the following factors were predictive of shorter locoregional relapse-free survival: age ≤ 40 (P < 0.0001), no PMRT (P = 0.034), fluorouracil/adriamycin/cyclophosphamide (FAC) chemotherapy (P = 0.001), and higher T stage (P = 0.002). CONCLUSION: The current analysis does not show a beneficial impact of PMRT on overall or relapse-free survival among patients with T1-T2 N1 disease who received standard adjuvant systemic therapy. There is, however, evidence of improvement in locoregional relapse-free survival with PMRT. These findings need to be prospectively validated.
PURPOSE: To assess the impact of postmastectomy radiotherapy (PMRT) on overall survival and relapse-free survival among breast cancerpatients with T1-T2 N1 disease who received standard adjuvant systemic therapy. METHODS: This is an individual patient data pooled analysis of 1053 breast cancerpatients referred for adjuvant therapy in three clinical trials (BIG 02/98, BCIRG001, and BCIRG005). Overall survival was assessed according to whether or not patients received adjuvant radiotherapy through Kaplan-Meier analysis. Univariate and multivariate analyses of predictors of overall and relapse-free survival were conducted through Cox regression analysis. RESULTS: Locoregional relapse rates (after a median follow up of 116 months) were 5.6% among patients who received adjuvant radiotherapy vs. 6.6% among patients who did not receive adjuvant radiotherapy. Actuarial 5‑ and 10-year locoregional relapse-free survival rates were 94 and 93%, respectively, among patients who did not receive adjuvant radiotherapy versus 95 and 92% among patients who received adjuvant radiotherapy. The following factors were associated with worse overall survival in multivariate Cox regression analysis: age < 40 years (P < 0.0001), T2 stage (P = 0.004), higher lymph node ratio (P < 0.0001), and negative hormone receptor status (P < 0.0001). Likewise, the following factors were predictive of shorter locoregional relapse-free survival: age ≤ 40 (P < 0.0001), no PMRT (P = 0.034), fluorouracil/adriamycin/cyclophosphamide (FAC) chemotherapy (P = 0.001), and higher T stage (P = 0.002). CONCLUSION: The current analysis does not show a beneficial impact of PMRT on overall or relapse-free survival among patients with T1-T2 N1 disease who received standard adjuvant systemic therapy. There is, however, evidence of improvement in locoregional relapse-free survival with PMRT. These findings need to be prospectively validated.
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