Outcomes of immediate oncoplastic surgery and adjuvant radiotherapy in breast cancer patients

BMC Cancer

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[1] 0000000123222966, grid.6936.a, Institute of Medical Informatics, Statistics and Epidemiology, Technical University Munich (TUM), Ismaninger Strasse 22, 81675, Munich, Germany;Department of Obstetrics and Gynecology, Technical University Munich, Medical School, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany;Department of Radiation Oncology, Faculty of Medicine, Technical University Munich (TUM), Medical School, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany;Department of Radiation Oncology, Faculty of Medicine, Technical University Munich (TUM), Medical School, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany;0000 0000 8517 6224, grid.275559.9, Department of Radiation Oncology, University Hospital Jena, Bachstraße 18, 07743, Jena, Germany;Department of Radiation Oncology, Faculty of Medicine, Technical University Munich (TUM), Medical School, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany;Deutsches Konsortium für Translationale Krebsforschung (DKTK)-Partner Site Munich, Munich, Germany;0000 0004 0483 2525, grid.4567.0, Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Ingolstädter Landstraße 1, Oberschleißheim, Germany;

关键词: Local control rate;    Oncoplastic surgery;    Adjuvant radiotherapy;    Boost definition;    Breast conserving therapy;   

DOI  :  10.1186/s12885-019-6104-4

来源: publisher

【 摘 要 】

BackgroundOncoplastic surgery techniques lead to a rearrangement of the breast tissue and impede target definition during adjuvant radiotherapy (RT). The aim of this study was to assess local control rates after immediate oncoplastic surgery and adjuvant RT.MethodsThis study comprises 965 patients who underwent breast-conserving therapy and adjuvant RT between 01/2000 and 12/2005. 288 patients received immediate oncoplastic surgery (ONC) and 677 patients breast-conserving surgery only (NONC). All patients were treated with adjuvant external tangential-beam RT (total dose: 50/50.4 Gy; fraction dose 1.8/2.0 Gy). An additional boost dose of 10–16 Gy to the primary tumor bed was given in 900 cases (93.3%). Local control rates (LCR), Progression free survival (PFS) and overall survival (OS) were assessed retrospectively after a median follow-up period of 67 (Q25-Q75: 51–84) months.ResultsNo significant difference was found between ONC and NONC in regard to LCR (5-yr: ONC 96.8% vs. NONC 95.3%; p = 0.25). This held also true for PFS (5-yr: ONC 92.1% vs. NONC 89.3%; p = 0.09) and OS (5-yr: ONC 96.0% vs. NONC 94.8%; p = 0.53). On univariate analyses G2–3 (p = 0.04), a younger age (p = 0.01), T-stage (p < 0.01) lymph node involvement (p < 0.01) as well as triple negative tumors (p < 0.01) were identified as risk factors for local recurrence. In a propensity score stratified Cox-regression model no significant impact of oncoplastic surgery on local control rate was found (HR: 2.05, 95% CI [0.93; 4.51], p = 0.08).ConclusionImmediate oncoplastic surgery seems not to affect the effectiveness of adjuvant whole breast RT on local control rates in breast cancer patients.

【 授权许可】

CC BY