The Effect of Simulation on Recurrence after Breast- Conserving Surgery and Radiotherapy: Preliminary Results
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Abstract
Purpose: To evaluate the effect of the simulation method on recurrence among the patients who received radiotherapy after breast-conserving surgery (BCS) for early breast carcinoma. Methods and Materials: Between 1995 and 2000, 70 patients with stage I-II breast carcinoma underwent breast-conserving surgery and adjuvant radiotherapy. Twenty nine patients (41.4%) were simulated with the 2D contour-based method (September 1995 to August 1997) and 41 patients (58.6%) were simulated with the 3D CT-based method (September 1997 to February 2000). To analyze the effect of the simulation method, the patient and treatment characteristics were compared. Results: The characteristics were similar for the patients between the 2D contour-based simulation group and the 3D CT-based simulation group. During a median follow-up period of 75 months, 4 (13.8%) of 29 patients who were treated with 2D simulation and 1 (2.4%) of 41 patients who were treated with 3D simulation group developed treatment failure. The five-year survival rates were 89.2% and 95.1% between the 2D and 3D simulation groups (p=0.196). The five-year disease free survival (DFS) rates were 86.2% and 97.5% between the 2D and 3D simulation groups (p=0.0636). On univariate analysis, age > 40 (p= 0.0226) and the number of dissected axillary lymph node ≥ 10 (p=0.0435) were independent predictors of improved 5-year DFS. Conclusions: Although our data showed marginal significance for the DFS between the two groups, it is insufficient, due to the small number of patients in our study, to prove whether 3D CT-based simulation might improve the DFS and reduce the risk of recurrence when compared with 2D contour-based simulation. Further study is needed with a larger group of patients. (Cancer Res Treat. 2006;38:40-47)
참고문헌 (24)
- "Twenty-year follow-up of a randomized trial comparing total mastectomy,lumpectomy,and lumpectomy plus irradiation for the treatment of invasive breast cancer", 347, pp.1233~41 (2002)
- "Twenty-year follow-up of a randomized study comparing breast conserving surgery with radical mastectomy for early breast cancer", 347, pp.1227~32 (2002)
- "Axillary lymph node with tangential breast irradiation", 61, pp.358~64 (2005)
- "Evaluation of a standard breast tangent technique: a dose-volume analysis of tangential irradiation using three-dimensional tools", 47, pp.327~33 (2000)
- "CT simulation for radiotherapy treatment planning", 75, pp.937~49 (2002)
- "AJCC American Joint Commitee on Cancer Manual for staging of cancer", pp.223~36 (2002), Lippincott
- "approaches for the management of stage I", II carcinoma of the breast: Milan Cancer Institute trials, 1994, pp.18, 70~5
- "Conservative surgery for the management of invasive and noninvasive carcinoma of the breast: NSABP trials. National surgical adjuvant breast and bowel project", 18, pp.63~9 (1994)
- "Relation of tumor size, lymph node status, and survival in 24740 breast cancer cases", 63, pp.181~7 (1989)
- "Factors influencing arm and axillary symptoms after treatment for node negative breast carcinoma", 97, pp.1369~75 (2003)
- "Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy", 29, pp.341~50 (2003)
- "Management of the axilla in operable cancer treated by breast conservation: a randomized clinical trial", 87, pp.163~9 (2000)
- "Axillary lymph nodes and breast cancer", 76, pp.1491~512 (1995)
- "A randomized comparison of sentinel-node biopsy with routine axilllary dissection in breast cancer", 349, pp.546~53 (2003)
- "Regional nodal failure after conservative surgery and radiotherapy for early stage breast carcinoma", 9, pp.988~96 (1991)
- "The evolving role of sentinel lymph node biopsy for breast cancer", 29, pp.423~5 (2003)
- "NSABP-32: Phase III, randomized trial comparing axillary resection with sentinal lymph node dissection: a description of the trial", 11(3), pp.208~10 (2004)
- "The recurrence of breast cancer after the breast conservation surgery", 26, pp.415~25 (1994)
- "Use of a CT simulator in radiotherapy treatment planning for breast conserving therapy", 33, pp.48~55 (1994)
- "Loco-regional conformal radiotherapy of the breast:delineation of the regional lymph node clinical target volumes in treatment position", 71, pp.287~95 (2004)
- "Cardiac and pulmonary doses and complication probabilities in standard and conformal tangential irradiation in conservative management of breast cancer", 62, pp.173~83 (2002)
- "Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation", 345, pp.1378~87 (2001)
- "Ratio between positive lymph nodes and total dissected axillaries lymph nodes as an independent prognostic factor for disease-free survival in patients with breast cancer", 27, pp.304~6 (2004)
- "Treatment results and prognostic factors of early breast cancer treated with a breast conserving operation and radiotherapy", 35, pp.126~33 (2005)
