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

Haeyoung Kim, Won Park, Jeong Il Yu, Doo Ho Choi, Seung Jae Huh, Yeon Joo Kim, Eun Sook Lee, Keun Seok Lee, Han Sung Kang, In Hae Park, Kyung Hwan Shin, Chan Woo Wee, Kyubo Kim, Kyung Ran Park, Yong Bae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung Sik LeeJung Soo Kim, Jihye Cha

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Abstract

Purpose 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. Materials and 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. Conclusion We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.

Original languageEnglish
Pages (from-to)970-980
Number of pages11
JournalCancer Research and Treatment
Volume49
Issue number4
DOIs
Publication statusPublished - 2017

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Kim, H., Park, W., Yu, J. I., Choi, D. H., Huh, S. J., Kim, Y. J., Lee, E. S., Lee, K. S., Kang, H. S., Park, I. H., Shin, K. H., Wee, C. W., Kim, K., Park, K. R., Kim, Y. B., Ahn, S. J., Lee, J. H., Kim, J. H., Chun, M., ... Cha, J. (2017). 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. Cancer Research and Treatment, 49(4), 970-980. https://doi.org/10.4143/crt.2016.382