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Her2/neu-positive disease does not increase risk of locoregional recurrence for patients treated with neoadjuvant doxorubicin-based chemotherapy, mastectomy, and radiotherapy.
- Source :
-
International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2004 Aug 01; Vol. 59 (5), pp. 1337-42. - Publication Year :
- 2004
-
Abstract
- Purpose: Preclinical data suggest that overexpression of Her2/neu confers cellular radioresistance. We retrospectively studied whether Her2/neu-positive disease was associated with locoregional recurrence (LRR) after postmastectomy radiotherapy (RT) for breast cancer.<br />Methods and Materials: Data from 337 patients treated in four institutional prospective clinical trials neoadjuvant doxorubicin-based chemotherapy, mastectomy, and RT were reviewed. The trials were conducted between 1989 and 2000. Of the 337 patients, 108 (32%) had tumors that were tested for Her2/neu, with positivity defined by 3+ immunohistochemistry staining or gene amplification detected by fluorescence in situ hybridization. RT was delivered to the chest wall and draining lymphatics (median dose, 50 Gy) followed by a chest wall boost (median dose, 10 Gy).<br />Results: Thirty-two patients had Her2/neu-positive disease and 76 patients had Her2/neu-negative disease. The Her2/neu-positive tumors were associated with a greater rate of estrogen receptor-negative disease (p = 0.03), the presence of supraclavicular disease at diagnosis (p = 0.027), and a greater number of positive lymph nodes after chemotherapy (p = 0.026). Despite these adverse features, the actuarial overall LRR rate was roughly equivalent for the patients with Her2/neu-positive tumors vs. those with Her2/neu-negative tumors (5-year rate 17.5% vs. 13.9%, respectively; 10-year rate 17.5% vs. 18.9%, respectively; p = 0.757). On Cox regression analysis of LRR adjusted for N stage and estrogen receptor status, the hazard ratio for Her2/neu positivity was 0.89 (95% confidence interval, 0.31-2.59; p = 0.83).<br />Conclusion: Her2/neu overexpression does not appear to predispose to LRR after neoadjuvant doxorubicin-based chemotherapy, mastectomy, and RT.
- Subjects :
- Adult
Antibiotics, Antineoplastic therapeutic use
Breast Neoplasms chemistry
Breast Neoplasms therapy
Chemotherapy, Adjuvant
Clinical Trials as Topic
Confidence Intervals
Doxorubicin therapeutic use
Drug Resistance, Neoplasm
Female
Humans
Lymphatic Metastasis
Mastectomy, Radical
Neoadjuvant Therapy
Radiation Tolerance
Receptors, Estrogen metabolism
Regression Analysis
Retrospective Studies
Breast Neoplasms metabolism
Neoplasm Proteins metabolism
Neoplasm Recurrence, Local metabolism
Receptor, ErbB-2 metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 0360-3016
- Volume :
- 59
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International journal of radiation oncology, biology, physics
- Publication Type :
- Academic Journal
- Accession number :
- 15275718
- Full Text :
- https://doi.org/10.1016/j.ijrobp.2004.02.018