Journal
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Volume 72, Issue 2, Pages 474-484Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ijrobp.2008.01.039
Keywords
inflammatory breast cancer; radiation dose; locoregional therapy
Funding
- NCI NIH HHS [T32CA77050, CA 16672, T32 CA077050, R01 CA138239-04, R01 CA138239-03, R01 CA138239-02, R01 CA138239, R01 CA138239-02S1, P30 CA016672] Funding Source: Medline
- NCRR NIH HHS [KL2 RR024149-01, KL2 RR024149, KL2 RR024149-02] Funding Source: Medline
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Purpose: The aims of this stud), were to determine outcomes for patients with inflammatory breast cancer (IBC) treated with multimodality therapy, to identify factors associated with locoregional recurrence, and to determine which patients may benefit from radiation dose escalation. Methods and Materials: We retrospectively reviewed 256 consecutive patients with nonmetastatic IBC treated at our institution between 1977 and 2004. Results: The 192 patients who were able to complete the planned course of chemotherapy, mastectomy, and postmastectomy radiation had significantly better outcomes than the 64 patients who did not. The respective 5-year outcome rates were: locoregional control (84% vs. 51%), distant metastasis-free survival (47% vs. 20%), and overall survival (51% vs. 24%) (p < 0.0001 for all comparisons). Univariate factors significantly associated with locoregional control in the patients who completed plan treatment were response to neoadjuvant chemotherapy, surgical margin status, number of involved lymph nodes, and use of taxanes. Increasing the total chest-wall dose of postmastectomy radiation from 60 Gy to 66 Gy significantly improved locoregional control for patients who experienced less than a partial response to chemotherapy, patients with positive, close, or unknown margins, and patients < 45 years of age. Conclusions: Patients with IBC who are able to complete treatment with chemotherapy, mastectomy, and postmastectomy radiation have a high probability of locoregional control. Escalation of postmastectomy radiation dose to 66 Gy appears to benefit patients with disease that responds poorly to chemotherapy, those with positive, close, or unknown margin status, and those < 45 years of age. (c) 2008 Elsevier Inc.
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