using Cox regression was used to assess the association of OS and variables including RT, age, and year of diagnosis. Results: 1382 patients diagnosed with TALL were identified. The median age at diagnosis was 9 years. There was a significant increase in the use of RT with 48.1% of patients between 2003 and 2012 receiving RT compared with 35.4% between 1980 and 2002 (P<0.001). Age at diagnosis and sex were not associated with differential use of radiation. On univariate analysis, RT was associated with an improvement in 5-year OS compared with no RT (81.6% vs. 73.7, P<0.001). OS was also improved for patients between 2003 and 2012 compared with 1980 and 2002 (84.8% vs. 69.0%, P<0.001), and age less than 10 years compared with age 10 years or older (80.6% vs. 73.1%, PZ0.001). On multivariate analysis, RT use (HRZ 0.672, PZ0.002), year of diagnosis between 2003 and 2012 (HRZ 0.464, P<0.001), and age at diagnosis <10 years (HRZ 0.635, P<0.001) all independently predicted for improved OS. Conclusion: In contrast to the majority of pediatric malignancies where RT use is decreasing, utilization of RT for TALL has been increasing. RT use is associated with improved OS independent of year of diagnosis and age of the patient. Limitations include the absence of data in the SEER database regarding chemotherapy, RT site, and CNS risk stratification of ALL patients.

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suggests that in pathological complete responders (CR) and luminal A subtype locoregional radiation therapy may be avoided. Hence we audited LABC patients treated over a 6 year period to correlate the pathological response and intrinsic subtype to LRR. Materials/Methods: Consecutive patients of LABC who underwent NACT (taxane and or anthracyclines based) followed by definitive surgery and RT during the period January 2007 to December 2012 were the subject of this analysis. The pathological response to NACT in tumor as well as axillary nodes [complete response (pCR), partial response (pPR)] and the intrinsic subtype of tumor (Luminal A, Luminal B, Her-2 type, triple negative) was correlated with patterns of locoregional recurrence by chi square test and Cox-regression tests at a median follow-up of 48 months. Results: Among 206 patients, the median age of patients was 46 years (range 24-81 years), 46% were premenopausal, and 54% postmenopausal, 42% right sided and 58% left sided. The clinical prechemotherapy status of tumor and node at presentation was 15% T2, 40% T3, 45% T4 (9% T4a, 35% T4b, 1% T4c) 8% N0, 42% N1, 41% N2, 9% N3.The intrinsic subtype of our population at presentation was Luminal A (16%), Luminal B (23%), Her-2 Type (23%), triple negative (37%).The overall pCR rate to NACT in tumor and in node was 31% and 45%.The pCR rate in tumor according to intrinsic subtype was 26%, 23%, 39% and 31.5% in Luminal A, Luminal B,Her-2 Type and triple negative type respectively. The pCR rate in node was 26%, 38%, 41.6%, and 59% in Luminal A, Luminal B, Her-2 Type and triple negative type respectively. At a median follow-up of 48 months (interquartile range 24-64 mo) the overall LRR was 7.2% (3.3% chest wall, 1.9% ipsilateral axilla, 1.9% ipsilateral supraclavicular fossa). All chest wall recurrences were in Her-2 and triple negative and recurrences in ipsilateral axilla and supraclavicular fossa were in triple negative and luminal B subtypes (P Z ns). T4b had a higher propensity of chest wall recurrence. Pathological response did not affect LRR (P Z ns). LRR was an independent predictor for overall survival in spite of adjusting for distant metastases (HR 4, P Z 0.000). Conclusion: The overall LRR is 7.2% and is predominantly seen in Her-2 neu, triple negative and luminal B subtypes. The intrinsic subtype and pathological response did not affect LRR.