For Stage II Node-Positive Breast Cancer, is it Worthwhile to Consider Adjuvant Radiotherapy Following Mastectomy?

Abstract

Purpose: To evaluate overall survival (OS), progression-free survival (PFS), loco-regional recurrence (LRR), and toxicities for early breast-cancer patients with one to three positive axillary lymph nodes, by the addition of radiotherapy to adjuvant chemotherapy.Patients and methods: Patients were eligible for enrollment into the study if they had pathologically proven stages II breast cancer, with one to three positive axillary lymph nodes. Patients were assigned to one of the two groups; Group 1; adjuvant chemotherapy then radiotherapy, and group 2; adjuvant chemotherapy only.Results: Between September 2008 and August 2014, 75 patients were enrolled. Forty patients group 1, and 35 group 2. The 4-year OS for group 1, and two were 77.5 and 71.4%, respectively. The 4-year PFS for group 1 and 2 were 72.5 and 60%, respectively. During the 54 months follow-up period, 11 patients from group 1 had recurrence (three locoregional, seven metastatic, and one both), and 14 patients from group 2 had recurrence (seven locoregional, three metastatic, and four both). The distant metastasis rate was the same in the two groups. However, the metastasis sites were different in the two groups.Conclusion: The addition of radiotherapy in stage II breast cancer with one to three positive lymph nodes improved the PFS, and LRR. Radiotherapy improved OS in patients with high-risk features.

Radiation Therapy for Breast Cancer in Africa

“…This study included 3 randomized controlled trials, 19 , 20 , 21 15 retrospective studies, 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 and 1 prospective study. 37 No case-control studies using radiation therapy within the period assessed in Africa was identified. In total, the 19 included studies recruited 4100 female patients with breast cancer with sample size ranging from 15 to 434 participants per study.…”

“… 25 , 29 , 34 The remaining 13 studies had no information on the DFS of patients treated with radiation therapy. 19 , 20 , 21 , 22 , 23 , 26 , 27 , 28 , 30 , 32 , 33 , 36 , 37 DFS was measured from the date of enrollment of patients to the date of first event (relapse, progression, or death from any cause) or to the last follow-up date. Based on the study of Osman et al, 37 PFS was calculated from the date of randomization of treatment to relapse, recurrence, or the last follow-up date.…”

“… 19 , 20 , 21 , 22 , 23 , 26 , 27 , 28 , 30 , 32 , 33 , 36 , 37 DFS was measured from the date of enrollment of patients to the date of first event (relapse, progression, or death from any cause) or to the last follow-up date. Based on the study of Osman et al, 37 PFS was calculated from the date of randomization of treatment to relapse, recurrence, or the last follow-up date. They reported that PFS rate at 4 years was 72.5% in patients treated with radiation therapy and 60% in those who received no radiation therapy, hence a 12.5% improvement in PFS.…”

“…Data on 2, 4, and 5 years’ local recurrences of breast cancer after radiation therapy treatment were extracted from 9 studies. 19 , 22 , 24 , 25 , 29 , 34 , 35 , 36 , 37 Six of the 9 studies reported on a significant reduction of relapse rate ranging from 5% to 12.5% for patients treated with radiation therapy compared with those who received no radiation therapy. 19 , 25 , 34 , 35 , 36 , 37 For participants in these 6 studies, the incidence of locoregional recurrence-free survival was reportedly improved, ranging from 88% to 95%.…”

Assessment of HER2+ Breast Cancer Management at Instituto Oncológico Nacional, Panama

“…The expected 5-year OS by treatment regimen and patient group was estimated with results from clinical trials and studies identi ed through secondary research (10)(11)(12)(13)(14)(15)(16)(17)(18). The OS from the reviewed sources was reported in different time frames or units, for example: median survival or hazard ratio to another known result.…”