Adjuvant regional nodal irradiation did not improve outcomes in T1-2N1 breast cancer after breast-conserving surgery: A propensity score matching analysis of BIG02/98 and BCIRG005 trials

Wei xiang Qi, Lu Cao, Cheng Xu, Shengguang Zhao, Jiayi Chen

Research output: Contribution to journalArticle

Abstract

Aim: To determine whether the addition of regional nodal irradiation (RNI) to whole-breast irradiation (WBI) would improve outcomes over WBI alone in T1-2N1 breast cancer after breast-conserving surgery (BCS) and adjuvant systematic therapy. Methods: Data were obtained from two randomized controlled trials (NCT00174655 and NCT00312208). Univariate and multivariate Cox-regression analysis were performed to investigate predictors for overall survival and disease-free survival. A 1:1 propensity score matching (PSM) analysis was applied to eliminate selection bias. Results: With median follow-up 80 months (range: 3–155 months), the 5-year local regional recurrence in the WBI group was 2% vs. 5% (p = 0.28) in the WBI + supraclavicular radiotherapy, and the rate of 5-year distant metastasis in the WBI group was 7% vs. 13% in the WBI + supraclavicular radiotherapy (p = 0.0748); In addition, the 5-year local regional recurrence in the WBI group was 3% vs. 9% (p = 0.19) in the WBI + internal mammary irradiation (IMI); However, the rate of 5-year distant metastasis in the in the WBI group was significantly lower than that in the WBI + IMI (8% vs. 24%, p = 0.036). After PSM, cox-regression analysis indicated that neither RNI nor IMI in combination with WBI in T1-2N1 breast cancer was associated with an improved overall survival and disease-free survival when compared to WBI alone. Conclusion: The addition of RNI to WBI in T1-2N1 breast cancer after BCS and adjuvant systematic therapy did not improve outcomes in comparison with WBI alone. Further studies are still needed to identify patients who would most benefit from RNI in this patient population.

Original languageEnglish (US)
Pages (from-to)165-170
Number of pages6
JournalBreast
Volume49
DOIs
StatePublished - Feb 2020

Fingerprint

Propensity Score
Segmental Mastectomy
Breast
Breast Neoplasms
Disease-Free Survival
Radiotherapy
Regression Analysis
Neoplasm Metastasis
Recurrence
Survival
Selection Bias

Keywords

  • Breast cancer
  • Breast conserving surgery
  • Propensity score matching analysis
  • Regional nodal irradiation
  • T1-2N1

ASJC Scopus subject areas

  • Surgery

Cite this

Adjuvant regional nodal irradiation did not improve outcomes in T1-2N1 breast cancer after breast-conserving surgery : A propensity score matching analysis of BIG02/98 and BCIRG005 trials. / Qi, Wei xiang; Cao, Lu; Xu, Cheng; Zhao, Shengguang; Chen, Jiayi.

In: Breast, Vol. 49, 02.2020, p. 165-170.

Research output: Contribution to journalArticle

@article{d6c6eab32b5f432fabedbe6d4bc6aa6d,
title = "Adjuvant regional nodal irradiation did not improve outcomes in T1-2N1 breast cancer after breast-conserving surgery: A propensity score matching analysis of BIG02/98 and BCIRG005 trials",
abstract = "Aim: To determine whether the addition of regional nodal irradiation (RNI) to whole-breast irradiation (WBI) would improve outcomes over WBI alone in T1-2N1 breast cancer after breast-conserving surgery (BCS) and adjuvant systematic therapy. Methods: Data were obtained from two randomized controlled trials (NCT00174655 and NCT00312208). Univariate and multivariate Cox-regression analysis were performed to investigate predictors for overall survival and disease-free survival. A 1:1 propensity score matching (PSM) analysis was applied to eliminate selection bias. Results: With median follow-up 80 months (range: 3–155 months), the 5-year local regional recurrence in the WBI group was 2{\%} vs. 5{\%} (p = 0.28) in the WBI + supraclavicular radiotherapy, and the rate of 5-year distant metastasis in the WBI group was 7{\%} vs. 13{\%} in the WBI + supraclavicular radiotherapy (p = 0.0748); In addition, the 5-year local regional recurrence in the WBI group was 3{\%} vs. 9{\%} (p = 0.19) in the WBI + internal mammary irradiation (IMI); However, the rate of 5-year distant metastasis in the in the WBI group was significantly lower than that in the WBI + IMI (8{\%} vs. 24{\%}, p = 0.036). After PSM, cox-regression analysis indicated that neither RNI nor IMI in combination with WBI in T1-2N1 breast cancer was associated with an improved overall survival and disease-free survival when compared to WBI alone. Conclusion: The addition of RNI to WBI in T1-2N1 breast cancer after BCS and adjuvant systematic therapy did not improve outcomes in comparison with WBI alone. Further studies are still needed to identify patients who would most benefit from RNI in this patient population.",
keywords = "Breast cancer, Breast conserving surgery, Propensity score matching analysis, Regional nodal irradiation, T1-2N1",
author = "Qi, {Wei xiang} and Lu Cao and Cheng Xu and Shengguang Zhao and Jiayi Chen",
year = "2020",
month = "2",
doi = "10.1016/j.breast.2019.11.001",
language = "English (US)",
volume = "49",
pages = "165--170",
journal = "Breast",
issn = "0960-9776",
publisher = "Churchill Livingstone",

}

TY - JOUR

T1 - Adjuvant regional nodal irradiation did not improve outcomes in T1-2N1 breast cancer after breast-conserving surgery

T2 - A propensity score matching analysis of BIG02/98 and BCIRG005 trials

AU - Qi, Wei xiang

AU - Cao, Lu

AU - Xu, Cheng

AU - Zhao, Shengguang

AU - Chen, Jiayi

PY - 2020/2

Y1 - 2020/2

N2 - Aim: To determine whether the addition of regional nodal irradiation (RNI) to whole-breast irradiation (WBI) would improve outcomes over WBI alone in T1-2N1 breast cancer after breast-conserving surgery (BCS) and adjuvant systematic therapy. Methods: Data were obtained from two randomized controlled trials (NCT00174655 and NCT00312208). Univariate and multivariate Cox-regression analysis were performed to investigate predictors for overall survival and disease-free survival. A 1:1 propensity score matching (PSM) analysis was applied to eliminate selection bias. Results: With median follow-up 80 months (range: 3–155 months), the 5-year local regional recurrence in the WBI group was 2% vs. 5% (p = 0.28) in the WBI + supraclavicular radiotherapy, and the rate of 5-year distant metastasis in the WBI group was 7% vs. 13% in the WBI + supraclavicular radiotherapy (p = 0.0748); In addition, the 5-year local regional recurrence in the WBI group was 3% vs. 9% (p = 0.19) in the WBI + internal mammary irradiation (IMI); However, the rate of 5-year distant metastasis in the in the WBI group was significantly lower than that in the WBI + IMI (8% vs. 24%, p = 0.036). After PSM, cox-regression analysis indicated that neither RNI nor IMI in combination with WBI in T1-2N1 breast cancer was associated with an improved overall survival and disease-free survival when compared to WBI alone. Conclusion: The addition of RNI to WBI in T1-2N1 breast cancer after BCS and adjuvant systematic therapy did not improve outcomes in comparison with WBI alone. Further studies are still needed to identify patients who would most benefit from RNI in this patient population.

AB - Aim: To determine whether the addition of regional nodal irradiation (RNI) to whole-breast irradiation (WBI) would improve outcomes over WBI alone in T1-2N1 breast cancer after breast-conserving surgery (BCS) and adjuvant systematic therapy. Methods: Data were obtained from two randomized controlled trials (NCT00174655 and NCT00312208). Univariate and multivariate Cox-regression analysis were performed to investigate predictors for overall survival and disease-free survival. A 1:1 propensity score matching (PSM) analysis was applied to eliminate selection bias. Results: With median follow-up 80 months (range: 3–155 months), the 5-year local regional recurrence in the WBI group was 2% vs. 5% (p = 0.28) in the WBI + supraclavicular radiotherapy, and the rate of 5-year distant metastasis in the WBI group was 7% vs. 13% in the WBI + supraclavicular radiotherapy (p = 0.0748); In addition, the 5-year local regional recurrence in the WBI group was 3% vs. 9% (p = 0.19) in the WBI + internal mammary irradiation (IMI); However, the rate of 5-year distant metastasis in the in the WBI group was significantly lower than that in the WBI + IMI (8% vs. 24%, p = 0.036). After PSM, cox-regression analysis indicated that neither RNI nor IMI in combination with WBI in T1-2N1 breast cancer was associated with an improved overall survival and disease-free survival when compared to WBI alone. Conclusion: The addition of RNI to WBI in T1-2N1 breast cancer after BCS and adjuvant systematic therapy did not improve outcomes in comparison with WBI alone. Further studies are still needed to identify patients who would most benefit from RNI in this patient population.

KW - Breast cancer

KW - Breast conserving surgery

KW - Propensity score matching analysis

KW - Regional nodal irradiation

KW - T1-2N1

UR - http://www.scopus.com/inward/record.url?scp=85075866838&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85075866838&partnerID=8YFLogxK

U2 - 10.1016/j.breast.2019.11.001

DO - 10.1016/j.breast.2019.11.001

M3 - Article

AN - SCOPUS:85075866838

VL - 49

SP - 165

EP - 170

JO - Breast

JF - Breast

SN - 0960-9776

ER -