The impact of postmastectomy radiotherapy on cT1-2N1 breast cancer patients with ypN0 after neoadjuvant chemotherapy: a retrospective study based on real-world data
作者全名："Dai, Yuran; Ma, Shishi; Lan, Ailin; Wang, Yihua; Wang, Yu; Jin, Yudi; Ding, Nan; Jiang, Linshan; Tang, Zhenrong; Yin, Xuedong; Peng, Yang; Liu, Shengchun"
作者地址："[Dai, Yuran; Lan, Ailin; Wang, Yihua; Ding, Nan; Jiang, Linshan; Tang, Zhenrong; Yin, Xuedong; Peng, Yang; Liu, Shengchun] Chongqing Med Univ, Affiliated Hosp 1, Dept Breast & Thyroid Surg, Chongqing, Peoples R China; [Ma, Shishi] Chongqing Med Univ, Dept Oncol, Affiliated Hosp 1, Chongqing, Peoples R China; [Wang, Yu] Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Gen Surg, State Key Lab Complex Severe & Rare Dis, Beijing, Peoples R China; [Jin, Yudi] Chongqing Univ, Dept Pathol, Canc Hosp, Chongqing, Peoples R China"
通信作者："Liu, SC (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Breast & Thyroid Surg, Chongqing, Peoples R China."
关键词：Breast cancer; Neoadjuvant chemotherapy; Post mastectomy radiotherapy
摘要："Background The role of postmastectomy radiation therapy (PMRT) in clinical T1-2N1 breast cancer patients who achieve axillary pathological complete response (ypN0) after neoadjuvant chemotherapy (NAC) is controversial.Methods Data from cT1-2N1 breast cancer patients who converted to ypN0 after NAC and subsequent surgery were retrospectively analyzed. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan?Meier method. Univariate and multivariate Cox regression models were applied to investigate the correlations between clinical or pathological parameters and survival.Results From 2012-2019, we identified 116 cases for analysis, including 31 (26.7%) who received PMRT and 85 (73.3%) who did not. At a median follow-up time of 56.4 months, the 5-year DFS and OS rates were 90.2% and 96.7% with PMRT and 93.7% and 97.3% without PMRT, respectively. PMRT did not affect either DFS (p = 0.234) or OS (p = 0.878). On multivariate analyses, no differences in DFS or OS between the two groups were detected, taking into consideration the following factors: age, molecular subtype, Ki67 index, cT stage, and in-breast pathologic complete response (DFS: HR 2.260; 95% CI 0.465-10.982; p = 0.312. OS: HR 1.400; 95% CI 0.138-14.202; p = 0.776). This nonsignificant difference was also consistent in subgroup analyses (all p > 0.05).Conclusions PMRT has limited ability to confer DFS or OS benefits for cT1-2N1 breast cancer patients who achieved axil-lary pathological complete response after NAC and total mastectomy. It is imperative to conduct prospective studies to investigate the safety and feasibility of omitting PMRT."
基金机构：Key Research and Development Project of Chongqing's Technology Innovation and Application Development Special Big Health Field; First-class Discipline Construction Project of Clinical Medicine in the First Clinical College of Chongqing Medical University [CSTC2021jscx-gksb-N0027]; 
基金资助正文："This work was funded by: 1. the Key Research and Development Project of Chongqing's Technology Innovation and Application Devel-opment Special Big Health Field (Grant No. CSTC2021jscx-gksb-N0027); 2. the First-class Discipline Construction Project of Clinical Medicine in the First Clinical College of Chongqing Medical University (Grant No. 472020320220007).The funding sources were not involved in study design, collection or analysis, and interpretation of data; nor in the writing of the report and in the decision to submit the article for publication."