Irradiation of regional nodes - affects overall survival

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cp418
cp418 Member Posts: 7,079
edited August 2015 in Clinical Trials, Research News, Podcasts, and Study Results

http://www.eortc.org/news/irradiation-of-regional-...

Irradiation of regional nodes in stage I – III breast cancer patients affects overall survival

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  • Stephmoen
    Stephmoen Member Posts: 563
    edited August 2015

    so is this saying that if your node negative and getting a mastectomy you should still get radiation?

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  • besa
    besa Member Posts: 1,088
    edited August 2015

    It looks like this study does not apply to just anyone with a bc diagnosis....

    "The study involved women with axillary node-positive (cancer in the lymph glandsunder the arm) or high-risk node-negative breast cancer (no cancer in under arm nodes, but cancer with bad prognostic features)."

    https://community.breastcancer.org/forum/73/topic/...

    A link below to the original New England Journal article:

    http://www.nejm.org/doi/full/10.1056/NEJMoa1415340...

    From: New England Journal of Medicine, July 23, 2015 | T.J. Whelan et. al.



    One thing -- the original EORTC link posted above states that there is a marginal difference between groups in survival. The original New England Journal article describes their results as "no significant difference between-group difference in survival" ... (P=0.38). To me that is not the same thing.

    "RESULTS

    Between March 2000 and February 2007, a total of 1832 women were assigned to the nodal-irradiation group or the control group (916 women in each group). The median follow-up was 9.5 years. At the 10-year follow-up, there was no significant between-group difference in survival, with a rate of 82.8% in the nodal-irradiation group and 81.8% in the control group (hazard ratio, 0.91; 95% confidence interval [CI], 0.72 to 1.13; P=0.38). The rates of disease-free survival were 82.0% in the nodal-irradiation group and 77.0% in the control group (hazard ratio, 0.76; 95% CI, 0.61 to 0.94; P=0.01). Patients in the nodal-irradiation group had higher rates of grade 2 or greater acute pneumonitis (1.2% vs. 0.2%, P=0.01) and lymphedema (8.4% vs. 4.5%, P=0.001)."


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  • Stephmoen
    Stephmoen Member Posts: 563
    edited August 2015

    I'm interested in this because they are saying I'm node neg according to a pet had neoadjuvant chemo so o don't know for sure by surgery I am her 2 so I fall into the bad prognostic features thinking of showing this to my drs I don't want radiation but if it will make me live longer well that's worth it

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  • besa
    besa Member Posts: 1,088
    edited August 2015

    Stephmoen - it sounds to me like you have a good plan. That way you know they are aware of the paper and you can see what their reasoning is in terms of recommendation. (When I read the article my take away was that there is no meaningful 10-year difference in overall survival between the 2 groups but there is a difference in disease free 10-year survival. On the other hand women in the irradiated group had higher rates of pneumonitis and lymphedema.)

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