Should all breast cancer patients with four or more positive lymph nodes who underwent modified radical mastectomy be treated with postoperative radiotherapy? A population-based study

Kong, Li; Zhang, Chenyue; Chen, Dawei; Zhu, Hui; J, Yu

doi:10.18632/oncotarget.12260

Cited by 8 publications

(3 citation statements)

References 30 publications

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“… 19 , 20 In fact, National Comprehensive Cancer Network and several other studies have regarded radiotherapy after MRM as standard treatment only for breast cancer patients with more than three PLNs. 12 , 21 Therefore, the number of three has been viewed a key point to determine adjuvant therapy for patients with breast cancer after MRM. Based on these scenarios, we only screened the appropriate breast cancer patients with more than three PLNs undergoing MRM.…”

Section: Discussionmentioning

confidence: 99%

How many ELNs are optimal for breast cancer patients with more than three PLNs who underwent MRM? A large population-based study

Wang¹,

Ji²,

Chi³

2018

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BackgroundFew studies have focused on the optimal threshold of examed lymph nodes (ELNs) for breast cancer patients with more than three positive lymph nodes after modified radical mastectomy.Materials and methodsThe X-tile and the minimum P-value models were applied to determine the optimal threshold. Cox proportional hazard analysis was used to analyze the cancer-specific survival and perform subgroup analysis.ResultsThe results showed that 12 ELNs was the optimal threshold for these patients, and the patients with >12 ELNs had a better cancer-specific survival benefit compared with the patients with <12 ELNs (P<0.001).ConclusionThe number 12 can be selected as the optimal threshold of ELNs for breast cancer patients with >3 positive lymph nodes after modified radical mastectomy.

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Section: Discussionmentioning

confidence: 99%

How many ELNs are optimal for breast cancer patients with more than three PLNs who underwent MRM? A large population-based study

Wang¹,

Ji²,

Chi³

2018

OTT

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“…Post mastectomy radiation therapy (PMRT), which significantly improves local tumor control and increases 5-year overall survival for breast cancer patients, is an effective and well-established adjuvant treatment for breast cancer patients with modified radical mastectomy [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Predictors of heart and lung dose in left-sided breast cancer treated with VMAT relative to 3D-CRT: A retrospective study

et al. 2021

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Background Before generating radiotherapy plans for breast cancer patients, the choice of plan techniques (three-dimensional conformal radiation therapy (3D-CRT) and volumetric modulated arc therapy (VMAT)) should be made. This study investigated the performance of two geometric indices in aiding the choice of 3D-CRT and VMAT plans in women undergoing left-sided whole breast radiotherapy. Materials and methods 119 patients, previously treated with left-sided breast radiotherapy (61 3D-CRT treatments and 58 VMAT treatments) from a single institution, were retrospectively studied. Two geometric indices, which were cardiac junction (CJ) index and pulmonary junction (PJ) index, were defined and the relationship between these indices and dose of organs at risk (OARs) were evaluated. Two-tailed Student’s t-test was performed to compare patient characteristics between 3D-CRT and VMAT. Linear regressions were calculated to investigate the association between geometric indices and absorbed dose of heart and left lung, including mean dose of heart (MHD), V5, V30 of heart, and mean dose of left lung (MLLD), V5, V10, V20, V30, V40 of left lung. Results The CJ index was strongly correlated with the MHD in 3D-CRT group and VMAT group. The linear regression formulas were MHD = 4826.59 ×CJ Index+310.48 (R = 0.857, F = 163.77, P = 0.000) in 3D-CRT plans and MHD = 1789.29×CJ Index+437.50 (R = 0.45, F = 14.23, P = 0.000) in VMAT plans. The intersection of the two formulas was CJ index = 4.2% and MHD = 512.33 cGy. The PJ index demonstrated a strongly positive correlation with MLLD in 3D-CRT group and VMAT group as well. The linear regression formulas were MLLD = 2879.54×PJ Index+999.79 (R = 0.697, F = 55.86, P = 0.000) in 3D-CRT plans and MLLD = 1411.79×PJ Index+1091.88 (R = 0.676, F = 47.11, P = 0.000) in VMAT plans, the intersection of the two formulas was PJ index = 6.3% and MLLD = 1180.46 cGy. Conclusions CJ index and PJ index could be used as a practical tool to select 3D-CRT or VMAT before generating plans. We recommend that VMAT plan is preferable when CJ index is greater than 4.2% and/or PJ index is greater than 14.6%, while 3D-CRT plan is the first choice in the opposite.

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“…Postmastectomy radiation therapy (PMRT), which signi cantly improves local tumor control and increase 5-year overall survival for breast cancer patients, is an effective and well-established adjuvant treatment for breast cancer patients with modi ed radical mastectomy [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Heart and Lung Dose in Left-sided Breast Cancer Treated with VMAT Relative to 3D-CRT：A Retrospective Study

Kang

Chen

Shi

et al. 2021

Preprint

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Background Before radiotherapy for breast cancer patients, the choice of three-dimensional conformal radiation therapy (3D-CRT) and volumetric modulated arc therapy (VMAT) should be made. This study investigates the performance of two structural metrics in aiding the choice of 3D-CRT and VMAT plans in women undergoing left-sided whole breast radiotherapy. Materials and methods 119 patients previously treated with left-sided breast radiotherapy (61 3D-CRT treatments and 58 VMAT treatments) from a single institution were retrospectively studied. Two structural metrics, which are cardiac intersetion (CI) index and pulmonary intersection (PI) index, were defined and the relationship between these metrics and dose of organs at risk (OARs) were evaluated. Two-tailed Student’s t-test was performed to compare patient characteristics between 3D-CRT and VMAT. Linear regressions were calculated to investigate the association between structural metrics and absorbed dose of heart and left lung, including MHD, V5, V30 of heart, and MLLD, V5, V10, V20, V30, V40 of left lung. Results The CI index was strongly correlated with the mean dose of heart (MHD) in 3D-CRT group and VMAT group, the linear regression formulas were MHD = 4826.59 ×CI Index + 310.48 (R = 0.857, F = 163.77, P = 0.000) in 3D-CRT plans and MHD = 1789.29×CI Index + 437.50 (R = 0.45, F = 14.23, P = 0.000) in VMAT plans, the intercept of these formulas was CI index = 4.2% and MHD = 512.33 cGy. The PI index demonstrated a strongly positive correlation with mean dose of left lung (MLLD) in 3D-CRT group and VMAT group as well, the linear regression formulas were MLLD = 2879.54×PI Index + 999.79 (R = 0.697, F = 55.86, P = 0.000) in 3D-CRT plans and MLLD = 1411.79×PI Index + 1091.88 (R = 0.676, F = 47.11, P = 0.000) in VMAT plans, the intercept of these formulas was PI index = 6.3% and MLLD = 1180.46 cGy. Conclusions CI index and PI index could serve as a practical tool of choosing either 3D-CRT or VMAT before the plan was generated. We recommend that VMAT plan is preferable when CI index is greater than 4.2% and PI index is greater than 14.6%, while 3D-CRT plan is the first choice in the opposite.

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Should all breast cancer patients with four or more positive lymph nodes who underwent modified radical mastectomy be treated with postoperative radiotherapy? A population-based study

Cited by 8 publications

References 30 publications

How many ELNs are optimal for breast cancer patients with more than three PLNs who underwent MRM? A large population-based study

How many ELNs are optimal for breast cancer patients with more than three PLNs who underwent MRM? A large population-based study

Predictors of heart and lung dose in left-sided breast cancer treated with VMAT relative to 3D-CRT: A retrospective study

Predictors of Heart and Lung Dose in Left-sided Breast Cancer Treated with VMAT Relative to 3D-CRT：A Retrospective Study

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