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

Affiliations
  • 1Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. radiat@snu.ac.kr
  • 2Department of Radiation Oncology, Konkuk University Medical Center, Seoul, Korea.
  • 3Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
  • 4Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
  • 5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

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
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