Cancer Res Treat.  2016 Apr;48(2):483-490. 10.4143/crt.2015.111.

Effect of Time Interval between Breast-Conserving Surgery and Radiation Therapy on Outcomes of Node-Positive Breast Cancer Patients Treated with Adjuvant Doxorubicin/Cyclophosphamide Followed by Taxane

• Koh HK
• Shin KH
• Kim K
• Lee ES
• Park IH
• Lee KS
• Ro J
• Jung SY
• Lee S
• Kim SW
• Kang HS
• Chie EK
• Han W
• Noh DY
• Lee KH
• Im SA
• Ha SW

• KMID: 2454324
• DOI: http://doi.org/10.4143/crt.2015.111

Abstract

PURPOSE
This study evaluated the effect of surgery-radiotherapy interval (SRI) on outcomes in patients treated with adjuvant radiotherapy (RT) after breast-conserving surgery (BCS) and adjuvant four cycles of doxorubicin/cyclophosphamide (AC) followed by four cycles of taxane.
MATERIALS AND METHODS
From 1999 to 2007, 397 eligible patients were diagnosed. The effect of SRI on outcomes was analyzed using a Cox proportional hazards model, and a maximal chi-square method was used to identify optimal cut-off value of SRI for each outcome.
RESULTS
The median SRI was 6.7 months (range, 5.6 to 10.3 months). A SRI of 7 months was the significant cut-off value for distant metastasis-free survival (DMFS) and disease-free survival (DFS) using a maximal chi-square method. For overall survival, a significant cut-off value was not found. The patients with SRI > 7 months had worse 6-year DMFS and DFS than those with SRI ≤ 7 months on univariate analysis (DMFS, 81% vs. 91%, p=0.003; DFS, 78% vs. 89%, p=0.002). On multivariate analysis, SRI > 7 months did not affect DMFS and DFS.
CONCLUSION
RT delayed for more than 7 months after BCS and adjuvant four cycles of AC followed by four cycles of taxane did not compromise clinical outcomes.

Keyword

Breast neoplasms; Segmental mastectomy; Time-to-treatment; Radiotherapy; Adjuvant chemotherapy

MeSH Terms

Breast Neoplasms*
Breast*
Chemotherapy, Adjuvant
Disease-Free Survival
Humans
Mastectomy, Segmental*
Methods
Multivariate Analysis
Proportional Hazards Models
Radiotherapy
Radiotherapy, Adjuvant
Time-to-Treatment

Figure

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  Fig. 1. Maximal chi-square method for distant metastasis-free survival (DMFS) (p=0.024). The cut-off value of surgery-radiotherapy interval (SRI) was set to what provided the best separation of DMFS into two groups, where the standardized log-rank statistics take their maximum.

• 

  Fig. 2. Maximal chi-square method for disease-free survival (DFS) (p=0.016). The cut-off value of surgery-radiotherapy interval (SRI) was set to what provided the best separation of DFS into two groups, where the standardized log-rank statistics take their maximum.

Reference

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