The Lack of Consensus of International Contouring Guidelines for the Dorsal Border of the Chest Wall Clinical Target Volume: What is the Impact on Organs at Risk and Relationships to Patterns of Recurrence in the Modern-Era?

Abstract

however the results did not reach significance (pZ.18). Local and regional first recurrent rates were 0% and 3.7% with comprehensive RT, compared to 10.6% and 12.8% with ALND and nodal RT. 2 patients who recurred in the ALND group showed simultaneous local and regional failure, making a locoregional failure rate of 23.4%. Distant failure rates were similar at 14.8% with RT and 14.9% with ALND. Lymphedema rates of 17.4% were seen with RT compared to 26.5% with ALND (pZ.39). Conclusion: Based on our findings, in patients who do not undergo ALND, a subset of women may benefit from comprehensive RT as it appears to be an effective means of local and regional disease control in patients with ypN+ disease. We encourage participation in Alliance A011202 to obtain randomized data in this cohort. We have an ongoing analysis to determine if the ALND group had higher risk features than the comprehensive RT group, which may have predisposed them to higher rates of failure.