Use of regional nodal irradiation and its association with survival for women with high-risk, early stage breast cancer: A National Cancer Database analysis
| العنوان: | Use of regional nodal irradiation and its association with survival for women with high-risk, early stage breast cancer: A National Cancer Database analysis |
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| المؤلفون: | Michael C. Stauder, Yu Shen, Yan Heather Lin, Wendy A. Woodward, Thomas A. Buchholz, Isabelle Bedrosian, Amy C. Moreno, Simona F. Shaitelman, Benjamin Smith, Gildy Babiera |
| المصدر: | Advances in Radiation Oncology Advances in Radiation Oncology, Vol 2, Iss 3, Pp 291-300 (2017) |
| بيانات النشر: | Elsevier, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | lcsh:Medical physics. Medical radiology. Nuclear medicine, Oncology, medicine.medical_specialty, Multivariate analysis, lcsh:R895-920, lcsh:RC254-282, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, Scientific Article, 030212 general & internal medicine, Stage (cooking), Proportional hazards model, business.industry, Hazard ratio, Cancer, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Confidence interval, 3. Good health, 030220 oncology & carcinogenesis, Propensity score matching, business |
| الوصف: | Purpose: The role of regional nodal irradiation (RNI) for patients with breast cancer remains controversial, particularly on the basis of nodal involvement. Using the National Cancer Database, we aimed to validate published data on whether expanding treatment fields from whole-breast irradiation (WBI) to encompass the regional nodes (WBI+RNI) affected overall survival (OS) for patients with node-positive (pN1-3) or high-risk node-negative (pN0) breast cancer treated with breast-conserving surgery and adjuvant chemotherapy. Methods and materials: Women diagnosed with invasive breast cancer between 2004 and 2012 who met the selection criteria for the National Cancer Institute of Canada MA.20 trial were identified and stratified by receipt of RNI. Propensity score matching was used to compare 1:1 matched pairs of patients. Five-year OS was estimated using the Kaplan-Meier method. We used multivariate logistic regression to predict receipt of WBI+RNI and a multivariable Cox model to examine associations between patients' demographic, tumor, and treatment characteristics and OS using double robust estimation. Results: Of 23,567 patients, 6,920 (29%) received WBI+RNI and 16,647 (71%) WBI. Median follow-up was 56 months. Use of WBI+RNI increased from 25.2% in 2004 to 32.2% in 2012 (P 1 involved node, and were not privately insured. For all patients, the 5-year OS rates were 90.8% with WBI+RNI versus 92.6% with WBI (P < .001). In the matched cohort (n = 10,922), the corresponding 5-year OS rates were 92% and 91.9% (P = .45), respectively. On multivariate analysis, WBI+RNI did not affect OS in the matched cohort (hazard ratio, 1.02; 95% confidence interval, 0.89-1.17, P = .76), regardless of pathologic nodal status. Conclusions: In this large retrospective analysis, use of WBI+RNI did not affect 5-year OS rates for women with high-risk, early stage breast cancer undergoing breast-conserving surgery and adjuvant chemotherapy, regardless of nodal status, which confirms the findings of the MA.20 trial. |
| اللغة: | English |
| تدمد: | 2452-1094 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cb306ce44b9714e545f498deb407f1a7 http://europepmc.org/articles/PMC5605314 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....cb306ce44b9714e545f498deb407f1a7 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 24521094 |
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