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J Korean Soc Ther Radiol Oncol > Volume 19(4); 2001 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2001;19(4): 312-318.
Postoperative Radiation Therapy in High-risk Breast Cancer
Kyung Ja Lee
To assess the locoregional recurrence rate, survival rate and prognostic factors after modified radical mastectomy and postoperative adjuvant radiation therapy with or with chemotherapy in high-risk breast cancer patients.
Between 1984-1995, 48 patients underwent postoperative irradiation to the regional lymphatics and chest wall due to large tumor size (> or = 5 cm) or small tumor size (<5 cm) with axillary lymph node involvement after modified radical mastectomy. The median age of the patients was 47 years (range, 31-79 years). The clinical tumor size was <2 cm in 1 patient, 2-5 cm in 15 patients, and >5 cm in 32 patients. Thirty two patients had positive axillary lymph nodes. Forty two patients were irradiated to the chest wall and regional lymph node and 6 patients were irradiated in the chest wall only. Radiation dose to the chest wall and regional lymph node was 5040 cGy/28 fraction. The median follow-up time was 61 months.
Locoregional recurrence rate was 8% and distant metastatic rate was 14%. The actuarial overall survival rate and disease-free survival rate was 63% and 62% at 5 years, respectively. The median survival time was 67 months. Five-year overall survival rate by the stage is 70% in IIB and 58% in IIIA. The significant prognostic factor for survival on multivariate analysis was the stage.
Postoperative adjuvant radiation therapy in high-risk breast cancer can reduce the locoregional recurrence rate and increase the survival time by combined chemotherapy. The significant prognostic factor for survival rate was the stage.
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