J Cancer 2021; 12(5):1548-1554. doi:10.7150/jca.51125

Research Paper

Integrated IMRT vs segmented 3D-CRT of the chest wall and supraclavicular region for Breast Cancer after modified Radical Mastectomy: An 8-year follow-up

Yutian Zhao1*, Jiahao Zhu1*, Xiaojun Zhang1, Gang Wu1, Yu Xu1, Peipei Shen1, Xianding Wei1, Dong Kong1, Shengjun Ji2✉, Bo Yang1✉

1. Department of Radiotherapy and Oncology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214000, P.R. China.
2. Department of Radiotherapy and Oncology, Suzhou Municipal Hospital, Suzhou, Jiangsu 215000, P.R. China.
*These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Citation:
Zhao Y, Zhu J, Zhang X, Wu G, Xu Y, Shen P, Wei X, Kong D, Ji S, Yang B. Integrated IMRT vs segmented 3D-CRT of the chest wall and supraclavicular region for Breast Cancer after modified Radical Mastectomy: An 8-year follow-up. J Cancer 2021; 12(5):1548-1554. doi:10.7150/jca.51125. Available from https://www.jcancer.org/v12p1548.htm

File import instruction

Abstract

Objective: The purpose of this study was to evaluate the efficacy of two radiotherapy techniques for breast cancer patients with post-mastectomy. The intensity-modulated radiotherapy for treating the chest wall and regional nodes contoured as a whole planning target volume was compared with the conventional segmented 3-dimensional conformal radiotherapy undergoing modified radical mastectomy.

Materials and methods: Patients who received the two post-mastectomy radiation therapies were retrospectively analyzed. The chest wall and supra/infraclavicular region +/- internal mammary nodes were contoured as a whole planning target volume on the planning computed tomography. We evaluated differences in survival, recurrence, and late side effects between the integrated intensity-modulated radiotherapy group and the conventional segmented group.

Results: A total of 223 patients were recruited. The mean follow-up was 104.3 months. Of these patients, 129 received integrated radiotherapy and 94 patients received segmented radiotherapy. The 8-year disease-free survival rates were 86.0% and 73.4% for patients treated with integrated radiotherapy and traditional segmented radiotherapy, respectively (P = 0.022). The 8-year overall survival rates were 91.4% and 86.2% for patients treated with integrated radiotherapy and traditional segmented radiotherapy, respectively (P = 0.530). Multivariate analysis demonstrated that radiotherapy was an independent prognostic factor for disease-free survival. No significant difference was observed in late side-effects between the two groups.

Conclusion: Intensity-modulated radiotherapy for treating the chest wall and regional nodes contoured as a whole planning target volume reduces the recurrence rate for post-mastectomy breast cancer patients with tolerable toxicities.

Keywords: breast cancer, modified radical mastectomy, intensity modulation, late toxicity