{Reference Type}: Journal Article
{Title}: Prognostic Impact of Elective Supraclavicular Nodal Irradiation for Patients with N1 Breast Cancer after Lumpectomy and Anthracycline Plus Taxane-Based Chemotherapy (KROG 1418): A Multicenter Case-Controlled Study.
{Author}: Kim H;Park W;Yu JI;Choi DH;Huh SJ;Kim YJ;Lee ES;Lee KS;Kang HS;Park IH;Shin KH;Wee CW;Kim K;Park KR;Kim YB;Ahn SJ;Lee JH;Kim JH;Chun M;Lee HS;Kim JS;Cha J;
{Journal}: Cancer Res Treat
{Volume}: 49
{Issue}: 4
{Year}: Oct 2017
{Factor}: 5.036
{DOI}: 10.4143/crt.2016.382
{Abstract}: OBJECTIVE: This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy.
METHODS: We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups.
RESULTS: A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI.
CONCLUSIONS: We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.