Outcomes of Patients With Breast Cancer Treated With or Without Internal Mammary Irradiation: A Single-Center, Retrospective Propensity Score–Matched Study
Purpose: Internal mammary lymph node radiation therapy (IMN-RT) has unclear benefits. Historical data were based on only conventional (2-dimensional) radiation techniques. In this 3-dimensional radiation therapy era, we compared the distant metastasis–free survival (DMFS) rates of patients receiving...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109422001786 |
| _version_ | 1811337493842231296 |
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| author | Tanun Jitwatcharakomol, MD Jiraporn Setakoranukul, MD Suthinee Ithimakin, MD Rungroj Krittayaphong, MD Kullathorn Thephamongkhol, MD |
| author_facet | Tanun Jitwatcharakomol, MD Jiraporn Setakoranukul, MD Suthinee Ithimakin, MD Rungroj Krittayaphong, MD Kullathorn Thephamongkhol, MD |
| author_sort | Tanun Jitwatcharakomol, MD |
| collection | DOAJ |
| description | Purpose: Internal mammary lymph node radiation therapy (IMN-RT) has unclear benefits. Historical data were based on only conventional (2-dimensional) radiation techniques. In this 3-dimensional radiation therapy era, we compared the distant metastasis–free survival (DMFS) rates of patients receiving IMN-RT with those who did not include coverage of the IMN (non–IMN-RT). This study aimed to determine the relationship between IMN-RT and distant metastasis control in patients with lymph node–positive breast cancer. Methods and Materials: This was a single-center retrospective cohort study. Patients were divided into 2 groups: IMN-RT and non–IMN-RT. The criterion of the IMN-RT group was that 80% of the prescribed dose covered ≥98% of the Clinical Target Volume of IMN. The primary outcome was 4-year DMFS, and the secondary outcomes were 4-year overall survival, 4-year disease-free survival, and cardiac toxicity. Results: From January 2012 to December 2018, 570 patients were evaluated (IMN-RT, 143 patients; non–IMN-RT, 427 patients). Propensity score matching decreased the number of patients in each group to 139. The median follow-up was 4.3 years. The 4-year DMFS rates were as follows: IMN-RT, 79.1% (95% confidence interval [CI], 70.1%-85.6%), and non–IMN-RT, 82.8% (95% CI, 74.2%-88.7%; P = .43). The groups’ 4-year overall survival and disease-free survival rates did not differ. The 4-year overall survival rates were 84.3% (95% CI, 76.4%-89.8%) for IMN-RT and 88.1% (95% CI, 81.0%-92.7%; P = .39) for non–IMN-RT. The 4-year disease-free survival rates were 77.1% (95% CI, 68.1%-83.8%) for IMN-RT and 82.1% (95% CI, 73.6%-88.1%; P = .29) for non–IMN-RT. There was no significant difference in cardiac toxicity (IMN-RT, 1.4%; non–IMN-RT, 1.4%; P = 1.0). Conclusions: In the modern radiation technique era with real-world data, we could not find a benefit of internal mammary irradiation. |
| first_indexed | 2024-04-13T17:55:41Z |
| format | Article |
| id | doaj.art-fcf7081fb882447bb0a750c4a79bc316 |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-04-13T17:55:41Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-fcf7081fb882447bb0a750c4a79bc3162022-12-22T02:36:31ZengElsevierAdvances in Radiation Oncology2452-10942023-01-0181101072Outcomes of Patients With Breast Cancer Treated With or Without Internal Mammary Irradiation: A Single-Center, Retrospective Propensity Score–Matched StudyTanun Jitwatcharakomol, MD0Jiraporn Setakoranukul, MD1Suthinee Ithimakin, MD2Rungroj Krittayaphong, MD3Kullathorn Thephamongkhol, MD4Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandFaculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandFaculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandFaculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandCorresponding author: Kullathorn Thephamongkhol, MD; Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandPurpose: Internal mammary lymph node radiation therapy (IMN-RT) has unclear benefits. Historical data were based on only conventional (2-dimensional) radiation techniques. In this 3-dimensional radiation therapy era, we compared the distant metastasis–free survival (DMFS) rates of patients receiving IMN-RT with those who did not include coverage of the IMN (non–IMN-RT). This study aimed to determine the relationship between IMN-RT and distant metastasis control in patients with lymph node–positive breast cancer. Methods and Materials: This was a single-center retrospective cohort study. Patients were divided into 2 groups: IMN-RT and non–IMN-RT. The criterion of the IMN-RT group was that 80% of the prescribed dose covered ≥98% of the Clinical Target Volume of IMN. The primary outcome was 4-year DMFS, and the secondary outcomes were 4-year overall survival, 4-year disease-free survival, and cardiac toxicity. Results: From January 2012 to December 2018, 570 patients were evaluated (IMN-RT, 143 patients; non–IMN-RT, 427 patients). Propensity score matching decreased the number of patients in each group to 139. The median follow-up was 4.3 years. The 4-year DMFS rates were as follows: IMN-RT, 79.1% (95% confidence interval [CI], 70.1%-85.6%), and non–IMN-RT, 82.8% (95% CI, 74.2%-88.7%; P = .43). The groups’ 4-year overall survival and disease-free survival rates did not differ. The 4-year overall survival rates were 84.3% (95% CI, 76.4%-89.8%) for IMN-RT and 88.1% (95% CI, 81.0%-92.7%; P = .39) for non–IMN-RT. The 4-year disease-free survival rates were 77.1% (95% CI, 68.1%-83.8%) for IMN-RT and 82.1% (95% CI, 73.6%-88.1%; P = .29) for non–IMN-RT. There was no significant difference in cardiac toxicity (IMN-RT, 1.4%; non–IMN-RT, 1.4%; P = 1.0). Conclusions: In the modern radiation technique era with real-world data, we could not find a benefit of internal mammary irradiation.http://www.sciencedirect.com/science/article/pii/S2452109422001786 |
| spellingShingle | Tanun Jitwatcharakomol, MD Jiraporn Setakoranukul, MD Suthinee Ithimakin, MD Rungroj Krittayaphong, MD Kullathorn Thephamongkhol, MD Outcomes of Patients With Breast Cancer Treated With or Without Internal Mammary Irradiation: A Single-Center, Retrospective Propensity Score–Matched Study Advances in Radiation Oncology |
| title | Outcomes of Patients With Breast Cancer Treated With or Without Internal Mammary Irradiation: A Single-Center, Retrospective Propensity Score–Matched Study |
| title_full | Outcomes of Patients With Breast Cancer Treated With or Without Internal Mammary Irradiation: A Single-Center, Retrospective Propensity Score–Matched Study |
| title_fullStr | Outcomes of Patients With Breast Cancer Treated With or Without Internal Mammary Irradiation: A Single-Center, Retrospective Propensity Score–Matched Study |
| title_full_unstemmed | Outcomes of Patients With Breast Cancer Treated With or Without Internal Mammary Irradiation: A Single-Center, Retrospective Propensity Score–Matched Study |
| title_short | Outcomes of Patients With Breast Cancer Treated With or Without Internal Mammary Irradiation: A Single-Center, Retrospective Propensity Score–Matched Study |
| title_sort | outcomes of patients with breast cancer treated with or without internal mammary irradiation a single center retrospective propensity score matched study |
| url | http://www.sciencedirect.com/science/article/pii/S2452109422001786 |
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