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The Role of Radiotherapy for Patients with Unresectable Locally Advanced Breast Cancer following Neoadjuvant Systemic Therapy

BACKGROUND: For locally advanced breast cancer (LABC) patients who remained unresectable after neoadjuvant systemic therapy (NST), radiotherapy (RT) is considered as an approach for tumor downstaging. In this study, we attempted to discuss the value of RT for patients with unresectable or progressiv...

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Autores principales: Wang, Xiaofang, Meng, Jin, Zhang, Xiaomeng, Zhang, Li, Chen, Xingxing, Yang, Zhaozhi, Mei, Xin, Yu, Xiaoli, Zhang, Zhen, Shao, Zhimin, Liu, Guangyu, Guo, Xiaomao, Ma, Jinli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9957626/
https://www.ncbi.nlm.nih.gov/pubmed/36844867
http://dx.doi.org/10.1155/2023/5101078
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author Wang, Xiaofang
Meng, Jin
Zhang, Xiaomeng
Zhang, Li
Chen, Xingxing
Yang, Zhaozhi
Mei, Xin
Yu, Xiaoli
Zhang, Zhen
Shao, Zhimin
Liu, Guangyu
Guo, Xiaomao
Ma, Jinli
author_facet Wang, Xiaofang
Meng, Jin
Zhang, Xiaomeng
Zhang, Li
Chen, Xingxing
Yang, Zhaozhi
Mei, Xin
Yu, Xiaoli
Zhang, Zhen
Shao, Zhimin
Liu, Guangyu
Guo, Xiaomao
Ma, Jinli
author_sort Wang, Xiaofang
collection PubMed
description BACKGROUND: For locally advanced breast cancer (LABC) patients who remained unresectable after neoadjuvant systemic therapy (NST), radiotherapy (RT) is considered as an approach for tumor downstaging. In this study, we attempted to discuss the value of RT for patients with unresectable or progressive disease in the breast and/or regional nodes following NST. METHODS: Between January 2013 and November 2020, the data for 71 patients with chemo-refractory LABC or de novo bone-only metastasis stage IV BC who received locoregional RT with or without surgical resection were retrospectively analyzed. Factors associated with tumor complete response (CR) were recognized using logistic regression. Locoregional progression-free survival (LRPFS) and progression-free survival (PFS) were calculated using the Kaplan–Meier method. The Cox regression model was applied to recognize the recurrence risk factors. RESULTS: After RT, 11 patients (15.5%) achieved total cCR. Triple-negative subtype (TNBC) was associated with a lower total cCR rate compared with other subtypes (p = 0.033). 26 patients proceeded to surgery, and the operability rate was 36.6%. 1-year LRPFS and PFS were 79.0% and 58.0%, respectively, for the entire cohort. Surgical cases had an improved 1-year LRPFS (p = 0.015), but not 1-year PFS (p = 0.057), compared with definitive RT cases. Non-any cCR was the most prominent predictor of a shorter LRPFS (p < 0.001) and PFS (p = 0.002) in the multivariate analysis. Higher TNM stage showed a trend toward a shorter LRPFS time (p = 0.058), and TNBC (p = 0.061) showed a trend toward a shorter PFS interval. CONCLUSIONS: This study demonstrated that RT was an effective tumor downstaging option for chemo-refractory LABC. For patients with favorable tumor regression, surgery following RT might bring survival benefits.
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spelling pubmed-99576262023-02-25 The Role of Radiotherapy for Patients with Unresectable Locally Advanced Breast Cancer following Neoadjuvant Systemic Therapy Wang, Xiaofang Meng, Jin Zhang, Xiaomeng Zhang, Li Chen, Xingxing Yang, Zhaozhi Mei, Xin Yu, Xiaoli Zhang, Zhen Shao, Zhimin Liu, Guangyu Guo, Xiaomao Ma, Jinli J Oncol Research Article BACKGROUND: For locally advanced breast cancer (LABC) patients who remained unresectable after neoadjuvant systemic therapy (NST), radiotherapy (RT) is considered as an approach for tumor downstaging. In this study, we attempted to discuss the value of RT for patients with unresectable or progressive disease in the breast and/or regional nodes following NST. METHODS: Between January 2013 and November 2020, the data for 71 patients with chemo-refractory LABC or de novo bone-only metastasis stage IV BC who received locoregional RT with or without surgical resection were retrospectively analyzed. Factors associated with tumor complete response (CR) were recognized using logistic regression. Locoregional progression-free survival (LRPFS) and progression-free survival (PFS) were calculated using the Kaplan–Meier method. The Cox regression model was applied to recognize the recurrence risk factors. RESULTS: After RT, 11 patients (15.5%) achieved total cCR. Triple-negative subtype (TNBC) was associated with a lower total cCR rate compared with other subtypes (p = 0.033). 26 patients proceeded to surgery, and the operability rate was 36.6%. 1-year LRPFS and PFS were 79.0% and 58.0%, respectively, for the entire cohort. Surgical cases had an improved 1-year LRPFS (p = 0.015), but not 1-year PFS (p = 0.057), compared with definitive RT cases. Non-any cCR was the most prominent predictor of a shorter LRPFS (p < 0.001) and PFS (p = 0.002) in the multivariate analysis. Higher TNM stage showed a trend toward a shorter LRPFS time (p = 0.058), and TNBC (p = 0.061) showed a trend toward a shorter PFS interval. CONCLUSIONS: This study demonstrated that RT was an effective tumor downstaging option for chemo-refractory LABC. For patients with favorable tumor regression, surgery following RT might bring survival benefits. Hindawi 2023-02-17 /pmc/articles/PMC9957626/ /pubmed/36844867 http://dx.doi.org/10.1155/2023/5101078 Text en Copyright © 2023 Xiaofang Wang et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Wang, Xiaofang
Meng, Jin
Zhang, Xiaomeng
Zhang, Li
Chen, Xingxing
Yang, Zhaozhi
Mei, Xin
Yu, Xiaoli
Zhang, Zhen
Shao, Zhimin
Liu, Guangyu
Guo, Xiaomao
Ma, Jinli
The Role of Radiotherapy for Patients with Unresectable Locally Advanced Breast Cancer following Neoadjuvant Systemic Therapy
title The Role of Radiotherapy for Patients with Unresectable Locally Advanced Breast Cancer following Neoadjuvant Systemic Therapy
title_full The Role of Radiotherapy for Patients with Unresectable Locally Advanced Breast Cancer following Neoadjuvant Systemic Therapy
title_fullStr The Role of Radiotherapy for Patients with Unresectable Locally Advanced Breast Cancer following Neoadjuvant Systemic Therapy
title_full_unstemmed The Role of Radiotherapy for Patients with Unresectable Locally Advanced Breast Cancer following Neoadjuvant Systemic Therapy
title_short The Role of Radiotherapy for Patients with Unresectable Locally Advanced Breast Cancer following Neoadjuvant Systemic Therapy
title_sort role of radiotherapy for patients with unresectable locally advanced breast cancer following neoadjuvant systemic therapy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9957626/
https://www.ncbi.nlm.nih.gov/pubmed/36844867
http://dx.doi.org/10.1155/2023/5101078
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