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局部晚期乳腺癌新辅助化疗后的手术治疗.pdf

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JournalofJBreastCancer2012September;15(3):329-336http://dx.doi.org/10.4048/jbc.2012.15.3.329 Breast Cancer ORIGINALARTICLE RadiationTreatmentinPathologicN0-N1PatientsTreatedwithNeoadjuvant ChemotherapyFollowedbySurgeryforLocallyAdvancedBreastCancer SunHyunBae,WonPark1,SeungJaeHuh1,DooHoChoi1,SeokJinNam2,Young-HyuckIm3,JinSeokAhn3 DepartmentofRadiationOncology,KoreaInstituteofRadiological&MedicalSciences,Seoul;Departmentsof1RadiationOncology,2Surgery,and3Division ofHematology-Oncology,DepartmentofMedicine,SamsungMedicalCenter,SungkyunkwanUniversitySchoolofMedicine,Seoul,Korea Purpose:Thisstudyevaluatedthetreatmentresultsandtheand91%,respectively.InpN0patients,LRRwas7%inSCNRT− necessitytoirradiatethesupraclavicularlymphnode(SCN)groupand5%inSCNRT+group.InpN1patients,LRRwas7% regioninpathologicalN0-N1(pN0-N1)patientswithlocallyinSCNRT-groupand6%inSCNRT+group.Therewasnosignif- advancedbreastcancertreatedwithneoadjuvantchemotherapyicantdifferenceofLRR,regardlessofSCNRT.However,inpN1 (NAC)followedbysurgeryandradiotherapy(RT).Methods:patients,thereweremorepatientswithpoorprognosticfactorsin Between1996and2008,184patientswithinitialtumorsize>5theSCNRT+groupcomparedtoSCNRT-group.Thesefactors cmorclinicallypositivelymphnodesweretreatedwithNACmightbeassociatedwithworseDFSintheSCNRT+group,even followedbysurgeryandRT.Amongthesepatients,weretrospec-thoughRTwasadministeredtotheSCNregion.Conclusion:Our tivelyreviewed98patientswithpN0-N1.Mastectomywasper-studyshowedthesimilarLRR,regardlessofSCNRTinpN0-pN1 formedin55%.ThepathologicallymphnodestagewasN0inbreastcancerpatientsafterNACfollowedbysurgery.Prospec- 49%andN1in51%.AllpatientsreceivedadjuvantRTtochesttiverandomizedtrialiscalledfortovalidatetheroleofSCNRT. wallorbreastand56patients(57%)alsoreceivedRTtothe SCNregion(SCNRT).Results:At5years,locoregionalrecurrence (LRR)-freesurvival,distantmetastasis-freesurvival,disease-freeKeyWords:Adjuvantradiotherapy,Breastneoplasms,Lymphaticirradiation, survival(DFS),andoverallsurvivalratesw