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  • [Breast.] Is tumor bed boost necessary in patients who achieved ypCR following neoadjuvant chemotherapy and breast conserving therapy? (KROG 12-05 and 16-16).수술전 항암치료와 유방보존수술후 ypCR 환자에서 Tumor bed boost 방사선치료 (KROG 12-05 and 16-16)

    성균관의대, 서울의대 / 조원경, 박원*, 김진호*

  • 출처
    Breast.
  • 등재일
    2019 Feb 26
  • 저널이슈번호
    45:43-47. doi: 10.1016/j.breast.2019.02.010. [Epub ahead of print]
  • 내용

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    Abstract
    PURPOSE:
    This multi-institutional study intended to investigate the effect of tumor bed boost in patients who achieved pathologic complete response (ypCR) following neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT).

    MATERIALS AND METHODS:
    We identified 180 patients who initially had lymph node (LN) metastasis and achieved ypCR (ypT0/isN0) following NAC and BCT from the 13 institutions of the Korean Radiation Oncology Group (KROG) 16-16 and KROG 12-05. The effect of tumor bed boost on loco-regional control (LRC), disease-free survival (DFS), and overall survival (OS) rates was analyzed.

    RESULTS:
    In all patients, five-year LRC, DFS and OS rates were 97.5%, 95.4%, and 99.4%, respectively. Tumor bed boost was performed in 158 (87.8%) patients. Advanced N-stage (cN2-3, p = 0.036), close resection margin (p < 0.001), and sentinel lymph node biopsy (p = 0.040) were unfavorable factors for DFS. Tumor bed boost was not a significant factor for LRC, DFS, and OS.

    CONCLUSIONS:
    This study suggests the benefit of tumor bed boost might be minimal in ypCR patients following NAC and BCT. Larger prospective studies are needed to address this issue.

     


    Author information

    Cho WK1, Park W2, Choi DH1, Kim YB3, Suh CO3, Shin KH4, Chie EK5, Kim JH6, Ahn SD7, Kim SS7, Kim K8, Kim JH9, Ahn SJ10, Lee SY11, Lee J12, Kim SW13, Kwon J14, Ahn KJ15, Shin HS16, Lee HS17, Lee NK18.
    1
    Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    2
    Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: wonro.park@samsung.com.
    3
    Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea.
    4
    Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea; Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Republic of Korea.
    5
    Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
    6
    Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: Jinho.kim.md@gmail.com.
    7
    Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
    8
    Department of Radiation Oncology, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
    9
    Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea.
    10
    Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea.
    11
    Department of Radiation Oncology, Chonbuk National University Medical School, Jeonju, Republic of Korea.
    12
    Department of Radiation Oncology, Inha University Hospital, Incheon, Republic of Korea.
    13
    Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Radiation Oncology, Konyang University College of Medicine, Daejeon, Republic of Korea.
    14
    Department of Radiation Oncology, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
    15
    Department of Radiation Oncology, Inje University Busan Paik Hospital, Busan, Republic of Korea.
    16
    Department of Radiation Oncology, Bundang CHA Hospital, Seoul, Republic of Korea.
    17
    Department of Radiation Oncology, Dong-A University Hospital, Busan, Republic of Korea.
    18
    Department of Radiation Oncology, Korea Medical Center, Seoul, Republic of Korea.

  • 키워드
    Breast cancer; Neoadjuvant chemotherapy; Radiotherapy; Tumor bed boost
  • 편집위원

    후향적 연구이지만 NAC 후 수술시 CR이 진단된 경우 boost가 항상 유용하지 않다는 결과로, clinical factor, patholgic factor, and biologic factor들을 고려하여 personalized approach가 필요함을 제시합니다.

    2019-07-18 15:11:45

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