4.6 Article

Integrated IMRT vs segmented 3D-CRT of the chest wall and supraclavicular region for Breast Cancer after modified Radical Mastectomy: An 8-year follow-up

Journal

JOURNAL OF CANCER
Volume 12, Issue 5, Pages 1548-1554

Publisher

IVYSPRING INT PUBL
DOI: 10.7150/jca.51125

Keywords

breast cancer; modified radical mastectomy; intensity modulation; late toxicity

Categories

Funding

  1. Wuxi science and education project [FZXK 004]
  2. Suzhou Cancer Clinical Medical Center [Szzx201506]
  3. Wefang Science and Technology Project [wfwsjs2018059]

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The study evaluated the efficacy of two radiotherapy techniques for post-mastectomy breast cancer patients. It found that intensity-modulated radiotherapy using whole planning target volume for chest wall and regional nodes reduced recurrence rate with tolerable toxicities.
Objective: The purpose of this study was to evaluate the efficacy of two radiotherapy techniques for breast cancer patients with post-mastectomy. The intensity-modulated radiotherapy for treating the chest wall and regional nodes contoured as a whole planning target volume was compared with the conventional segmented 3-dimensional conformal radiotherapy undergoing modified radical mastectomy. Materials and methods: Patients who received the two post-mastectomy radiation therapies were retrospectively analyzed. The chest wall and supra/infraclavicular region +/-internal mammary nodes were contoured as a whole planning target volume on the planning computed tomography. We evaluated differences in survival, recurrence, and late side effects between the integrated intensity-modulated radiotherapy group and the conventional segmented group. Results: A total of 223 patients were recruited. The mean follow-up was 104.3 months. Of these patients, 129 received integrated radiotherapy and 94 patients received segmented radiotherapy. The 8-year disease-free survival rates were 86.0% and 73.4% for patients treated with integrated radiotherapy and traditional segmented radiotherapy, respectively (P = 0.022). The 8-year overall survival rates were 91.4% and 86.2% for patients treated with integrated radiotherapy and traditional segmented radiotherapy, respectively (P = 0.530). Multivariate analysis demonstrated that radiotherapy was an independent prognostic factor for disease-free survival. No significant difference was observed in late side-effects between the two groups. Conclusion: Intensity-modulated radiotherapy for treating the chest wall and regional nodes contoured as a whole planning target volume reduces the recurrence rate for post-mastectomy breast cancer patients with tolerable toxicities.

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