title: Prognostic Impact of Elective Supraclavicular Nodal Irradiation for Patients with N1 Breast Cancer after Lumpectomy and Anthracycline Plus Taxane-Based Chemotherapy (KROG 1418): A Multicenter Case-Controlled Study.
abstract: OBJECTIVE
  This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy.
  
  
  METHODS
  We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups.
  
  
  RESULTS
  A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI.
  
  
  CONCLUSIONS
  We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.
authors.affiliation: Department of Radiation Oncology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
authors.forename: Haeyoung
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Won
authors.initials: W
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jeong Il
authors.initials: JI
authors.lastname: Yu
authors.affiliation: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Doo Ho
authors.initials: DH
authors.lastname: Choi
authors.affiliation: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seung Jae
authors.initials: SJ
authors.lastname: Huh
authors.affiliation: Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Yeon-Joo
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Lee
authors.affiliation: Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Keun Seok
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Han-Sung
authors.initials: HS
authors.lastname: Kang
authors.affiliation: Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: In Hae
authors.initials: IH
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyung Hwan
authors.initials: KH
authors.lastname: Shin
authors.affiliation: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Chan Woo
authors.initials: CW
authors.lastname: Wee
authors.affiliation: Department of Radiation Oncology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Kyubo
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Kyung Ran
authors.initials: KR
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Bae
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sung Ja
authors.initials: SJ
authors.lastname: Ahn
authors.affiliation: Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Jong Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Mison
authors.initials: M
authors.lastname: Chun
authors.affiliation: Department of Radiation Oncology, Dong-A University Hospital, Dong-A University School of Medicine, Busan, Korea.
authors.forename: Hyung-Sik
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Wonju Severance Christian Hospital, Wonju, Korea.
authors.forename: Jihye
authors.initials: J
authors.lastname: Cha
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care; D011379:Prognosis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines; D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane
keywords: Adjuvant radiotherapy; Breast neoplasms; Case-control studies; Lymphatic irradiation; Taxane