The Impact of Post-Mastectomy Radiotherapy on Survival Outcomes in Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy
Simple Summary The benefits of post-mastectomy radiotherapy (PMRT) may vary depending on patients' responses to neoadjuvant chemotherapy (NAC), although PMRT is useful for patients who underwent NAC. One can consider omitting PMRT in patients who have achieved pathologic complete response or wh...
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| Veröffentlicht in: | Cancers 2021-12, Vol.13 (24), p.6205, Article 6205 |
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| creator | Lee, Janghee Kim, Jee-Ye Bae, Soong-June Cho, Yeona Ji, Jung-Hwan Kim, Dooreh Ahn, Sung-Gwe Park, Hyung-Seok Park, Seho Kim, Seung-Il Park, Byeong-Woo Jeong, Joon |
| description | Simple Summary The benefits of post-mastectomy radiotherapy (PMRT) may vary depending on patients' responses to neoadjuvant chemotherapy (NAC), although PMRT is useful for patients who underwent NAC. One can consider omitting PMRT in patients who have achieved pathologic complete response or who have minimal residual disease, with a neoadjuvant response index value of 0.7-1.0. This study aimed to determine whether post-mastectomy radiotherapy (PMRT) is beneficial for the prognosis of patients who achieved pathologic complete response (pCR), or who had minimal residual disease, after undergoing neoadjuvant chemotherapy (NAC). Patients who underwent a total mastectomy between 2006 and 2018, after NAC, were included. Patients who did not receive PMRT were matched using 1:3 propensity score matching (PSM). Kaplan-Meier survival curves were used to compare locoregional recurrence-free survival (LRRFS) and overall survival (OS). A total of 368 patients were included after 1:3 PSM. PMRT improved the LRRFS (p = 0.016) and OS (p = 0.017) rates of patients who underwent NAC. However, PMRT did not affect the prognosis of patients with pCR (LRRFS: p = 0.999; OS: p = 0.453). In addition, PMRT had a limited effect on LRRFS and OS in patients who responded well to NAC, with a neoadjuvant response index (NRI) value of 0.7-1.0 (LRRFS: p = 0.568; OS: p = 0.875). PMRT improved the OS of patients with a large residual tumor burden, such as nodal metastases or pathologic stage II/III. The benefits of PMRT vary depending on the patients' response to NAC, although PMRT is useful for treating patients who underwent NAC. PMRT can be omitted, not only in patients with pCR, but also in good responders with an NRI value of 0.7-1.0. |
| doi_str_mv | 10.3390/cancers13246205 |
| format | Article |
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One can consider omitting PMRT in patients who have achieved pathologic complete response or who have minimal residual disease, with a neoadjuvant response index value of 0.7-1.0. This study aimed to determine whether post-mastectomy radiotherapy (PMRT) is beneficial for the prognosis of patients who achieved pathologic complete response (pCR), or who had minimal residual disease, after undergoing neoadjuvant chemotherapy (NAC). Patients who underwent a total mastectomy between 2006 and 2018, after NAC, were included. Patients who did not receive PMRT were matched using 1:3 propensity score matching (PSM). Kaplan-Meier survival curves were used to compare locoregional recurrence-free survival (LRRFS) and overall survival (OS). A total of 368 patients were included after 1:3 PSM. PMRT improved the LRRFS (p = 0.016) and OS (p = 0.017) rates of patients who underwent NAC. However, PMRT did not affect the prognosis of patients with pCR (LRRFS: p = 0.999; OS: p = 0.453). In addition, PMRT had a limited effect on LRRFS and OS in patients who responded well to NAC, with a neoadjuvant response index (NRI) value of 0.7-1.0 (LRRFS: p = 0.568; OS: p = 0.875). PMRT improved the OS of patients with a large residual tumor burden, such as nodal metastases or pathologic stage II/III. The benefits of PMRT vary depending on the patients' response to NAC, although PMRT is useful for treating patients who underwent NAC. PMRT can be omitted, not only in patients with pCR, but also in good responders with an NRI value of 0.7-1.0.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers13246205</identifier><identifier>PMID: 34944827</identifier><language>eng</language><publisher>BASEL: Mdpi</publisher><subject>Breast cancer ; Cancer therapies ; Chemotherapy ; Life Sciences & Biomedicine ; Mammography ; Mastectomy ; Medical diagnosis ; Medical prognosis ; Metastases ; Metastasis ; Minimal residual disease ; Oncology ; Patients ; Prognosis ; Radiation therapy ; Science & Technology ; Surgery ; Survival ; Tumors</subject><ispartof>Cancers, 2021-12, Vol.13 (24), p.6205, Article 6205</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>4</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000736135200001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c421t-14655fe7d26bd1f2fb64358dd7b42018530574525c00c06763b4ea4569b694023</citedby><cites>FETCH-LOGICAL-c421t-14655fe7d26bd1f2fb64358dd7b42018530574525c00c06763b4ea4569b694023</cites><orcidid>0000-0002-1202-0880 ; 0000-0001-9673-2748 ; 0000-0002-8778-9686 ; 0000-0001-8089-2755 ; 0000-0003-1790-0788 ; 0000-0003-1172-535X ; 0000-0003-0397-0005 ; 0000-0002-0012-9694</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8699474/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8699474/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,39263,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34944827$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Janghee</creatorcontrib><creatorcontrib>Kim, Jee-Ye</creatorcontrib><creatorcontrib>Bae, Soong-June</creatorcontrib><creatorcontrib>Cho, Yeona</creatorcontrib><creatorcontrib>Ji, Jung-Hwan</creatorcontrib><creatorcontrib>Kim, Dooreh</creatorcontrib><creatorcontrib>Ahn, Sung-Gwe</creatorcontrib><creatorcontrib>Park, Hyung-Seok</creatorcontrib><creatorcontrib>Park, Seho</creatorcontrib><creatorcontrib>Kim, Seung-Il</creatorcontrib><creatorcontrib>Park, Byeong-Woo</creatorcontrib><creatorcontrib>Jeong, Joon</creatorcontrib><title>The Impact of Post-Mastectomy Radiotherapy on Survival Outcomes in Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy</title><title>Cancers</title><addtitle>CANCERS</addtitle><addtitle>Cancers (Basel)</addtitle><description>Simple Summary The benefits of post-mastectomy radiotherapy (PMRT) may vary depending on patients' responses to neoadjuvant chemotherapy (NAC), although PMRT is useful for patients who underwent NAC. 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In addition, PMRT had a limited effect on LRRFS and OS in patients who responded well to NAC, with a neoadjuvant response index (NRI) value of 0.7-1.0 (LRRFS: p = 0.568; OS: p = 0.875). PMRT improved the OS of patients with a large residual tumor burden, such as nodal metastases or pathologic stage II/III. The benefits of PMRT vary depending on the patients' response to NAC, although PMRT is useful for treating patients who underwent NAC. PMRT can be omitted, not only in patients with pCR, but also in good responders with an NRI value of 0.7-1.0.</description><subject>Breast cancer</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Life Sciences & Biomedicine</subject><subject>Mammography</subject><subject>Mastectomy</subject><subject>Medical diagnosis</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Minimal residual disease</subject><subject>Oncology</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Survival</subject><subject>Tumors</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkk1v1DAQhiNERavSMzdkiQsSSutvJxckiKCt1NIKWnGMHGdCskrsxXa22hs_vV62XZWe8MUz8jOvZvxOlr0h-JixEp8YbQ34QBjlkmLxIjugWNFcypK_fBLvZ0chLHA6jBEl1atsn_GS84Kqg-zPTQ_ofFpqE5Hr0LULMb_UIYKJblqj77odXOzB6-UaOYt-zH41rPSIruZo3AQBDRZ99pAqUPW3HXSt4wA2BvSzd-jWtuDvUoq-gdPtYl7pFFc9TI-qr7O9To8Bjh7uw-z265eb6iy_uDo9rz5d5IZTEnPCpRAdqJbKpiUd7RrJmSjaVjWcYlIIhoXiggqDscFSSdZw0FzIsklfgCk7zD5udZdzM0FrUk9ej_XSD5P269rpof73xQ59_cut6kKWJVc8Cbx_EPDu9wwh1tMQDIyjtuDmUFNJOGWK8CKh756hCzd7m8bbUFQxhQlO1MmWMt6F4KHbNUNwvTG4fmZwqnj7dIYd_2hnAj5sgTtoXBdMMsLADksboJgkTNDNMpBEF_9PV0NMxjpbudlGdg-v4sQ5</recordid><startdate>20211209</startdate><enddate>20211209</enddate><creator>Lee, Janghee</creator><creator>Kim, Jee-Ye</creator><creator>Bae, Soong-June</creator><creator>Cho, Yeona</creator><creator>Ji, Jung-Hwan</creator><creator>Kim, Dooreh</creator><creator>Ahn, Sung-Gwe</creator><creator>Park, Hyung-Seok</creator><creator>Park, Seho</creator><creator>Kim, Seung-Il</creator><creator>Park, Byeong-Woo</creator><creator>Jeong, Joon</creator><general>Mdpi</general><general>MDPI AG</general><general>MDPI</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1202-0880</orcidid><orcidid>https://orcid.org/0000-0001-9673-2748</orcidid><orcidid>https://orcid.org/0000-0002-8778-9686</orcidid><orcidid>https://orcid.org/0000-0001-8089-2755</orcidid><orcidid>https://orcid.org/0000-0003-1790-0788</orcidid><orcidid>https://orcid.org/0000-0003-1172-535X</orcidid><orcidid>https://orcid.org/0000-0003-0397-0005</orcidid><orcidid>https://orcid.org/0000-0002-0012-9694</orcidid></search><sort><creationdate>20211209</creationdate><title>The Impact of Post-Mastectomy Radiotherapy on Survival Outcomes in Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy</title><author>Lee, Janghee ; Kim, Jee-Ye ; Bae, Soong-June ; Cho, Yeona ; Ji, Jung-Hwan ; Kim, Dooreh ; Ahn, Sung-Gwe ; Park, Hyung-Seok ; Park, Seho ; Kim, Seung-Il ; Park, Byeong-Woo ; Jeong, Joon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-14655fe7d26bd1f2fb64358dd7b42018530574525c00c06763b4ea4569b694023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Breast cancer</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Life Sciences & Biomedicine</topic><topic>Mammography</topic><topic>Mastectomy</topic><topic>Medical diagnosis</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Minimal residual disease</topic><topic>Oncology</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Radiation therapy</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Survival</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Janghee</creatorcontrib><creatorcontrib>Kim, Jee-Ye</creatorcontrib><creatorcontrib>Bae, Soong-June</creatorcontrib><creatorcontrib>Cho, Yeona</creatorcontrib><creatorcontrib>Ji, Jung-Hwan</creatorcontrib><creatorcontrib>Kim, Dooreh</creatorcontrib><creatorcontrib>Ahn, Sung-Gwe</creatorcontrib><creatorcontrib>Park, Hyung-Seok</creatorcontrib><creatorcontrib>Park, Seho</creatorcontrib><creatorcontrib>Kim, Seung-Il</creatorcontrib><creatorcontrib>Park, Byeong-Woo</creatorcontrib><creatorcontrib>Jeong, Joon</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Janghee</au><au>Kim, Jee-Ye</au><au>Bae, Soong-June</au><au>Cho, Yeona</au><au>Ji, Jung-Hwan</au><au>Kim, Dooreh</au><au>Ahn, Sung-Gwe</au><au>Park, Hyung-Seok</au><au>Park, Seho</au><au>Kim, Seung-Il</au><au>Park, Byeong-Woo</au><au>Jeong, Joon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Impact of Post-Mastectomy Radiotherapy on Survival Outcomes in Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy</atitle><jtitle>Cancers</jtitle><stitle>CANCERS</stitle><addtitle>Cancers (Basel)</addtitle><date>2021-12-09</date><risdate>2021</risdate><volume>13</volume><issue>24</issue><spage>6205</spage><pages>6205-</pages><artnum>6205</artnum><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>Simple Summary The benefits of post-mastectomy radiotherapy (PMRT) may vary depending on patients' responses to neoadjuvant chemotherapy (NAC), although PMRT is useful for patients who underwent NAC. One can consider omitting PMRT in patients who have achieved pathologic complete response or who have minimal residual disease, with a neoadjuvant response index value of 0.7-1.0. This study aimed to determine whether post-mastectomy radiotherapy (PMRT) is beneficial for the prognosis of patients who achieved pathologic complete response (pCR), or who had minimal residual disease, after undergoing neoadjuvant chemotherapy (NAC). Patients who underwent a total mastectomy between 2006 and 2018, after NAC, were included. Patients who did not receive PMRT were matched using 1:3 propensity score matching (PSM). Kaplan-Meier survival curves were used to compare locoregional recurrence-free survival (LRRFS) and overall survival (OS). A total of 368 patients were included after 1:3 PSM. PMRT improved the LRRFS (p = 0.016) and OS (p = 0.017) rates of patients who underwent NAC. However, PMRT did not affect the prognosis of patients with pCR (LRRFS: p = 0.999; OS: p = 0.453). In addition, PMRT had a limited effect on LRRFS and OS in patients who responded well to NAC, with a neoadjuvant response index (NRI) value of 0.7-1.0 (LRRFS: p = 0.568; OS: p = 0.875). PMRT improved the OS of patients with a large residual tumor burden, such as nodal metastases or pathologic stage II/III. The benefits of PMRT vary depending on the patients' response to NAC, although PMRT is useful for treating patients who underwent NAC. PMRT can be omitted, not only in patients with pCR, but also in good responders with an NRI value of 0.7-1.0.</abstract><cop>BASEL</cop><pub>Mdpi</pub><pmid>34944827</pmid><doi>10.3390/cancers13246205</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-1202-0880</orcidid><orcidid>https://orcid.org/0000-0001-9673-2748</orcidid><orcidid>https://orcid.org/0000-0002-8778-9686</orcidid><orcidid>https://orcid.org/0000-0001-8089-2755</orcidid><orcidid>https://orcid.org/0000-0003-1790-0788</orcidid><orcidid>https://orcid.org/0000-0003-1172-535X</orcidid><orcidid>https://orcid.org/0000-0003-0397-0005</orcidid><orcidid>https://orcid.org/0000-0002-0012-9694</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; PubMed Central |
| subjects | Breast cancer Cancer therapies Chemotherapy Life Sciences & Biomedicine Mammography Mastectomy Medical diagnosis Medical prognosis Metastases Metastasis Minimal residual disease Oncology Patients Prognosis Radiation therapy Science & Technology Surgery Survival Tumors |
| title | The Impact of Post-Mastectomy Radiotherapy on Survival Outcomes in Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy |
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