Predictors of locoregional outcome in patients receiving neoadjuvant therapy and postmastectomy radiation

作者：Jean L. Wright, Cristiane Takita, Isildinha Marques dos Reis, Wei K. Zhao, Kunal Saigal, Aaron Howard Wolfson, Arnold M. Markoe, Mecker Geraldine Moller, Judith E. Hurley · 发表于：Cancer · 年份：2012 · DOI：10.1002/cncr.27717 · 被引用次数：48 · 研究领域：Breast Cancer Treatment Studies、Breast Implant and Reconstruction、Breast Lesions and Carcinomas

BACKGROUND: The objective of this study was to identify predictors of locoregional recurrence (LRR) after neoadjuvant therapy (NAT) and postmastectomy radiation (PMRT) in a cohort of patients with stage II through III breast cancer and to determine whether omission of the supraclavicular field had an impact on the risk of LRR. METHODS: The authors reviewed records from 464 patients who received NAT and PMRT from January 1999 to December 2009. RESULTS: The median patient age was 50 years (range, 25-81 years). Clinical disease stage was stage II in 29% of patients, stage III in 71%, and inflammatory in 14%. Receptor status was estrogen receptor (ER)-positive in 54% of patients, progesterone receptor (PR)-positive in 39%, human epidermal growth factor receptor 2 (HER2)-positive in 24%, and negative for all 3 receptors (triple negative) in 32%. All patients received NAT and underwent mastectomy, and 19.6% had a complete pathologic response in the breast and axilla, 17.5% received radiation to the chest wall only, and 82.5% received radiation to the chest wall and the supraclavicular field; omission of the supraclavicular field was more common in patients with lower clinical and pathologic lymph node status. The median follow-up was 50.5 months, and the 5-year cumulative incidence of LRR was 6% (95% confidence interval, 3.9%-8.6%). Predictors of LRR were clinical stage III (P = .038), higher clinical lymph node status (P = .025), higher pathologic lymph node status (P = .003), the...