Lymphedema after regional nodal irradiation for breast cancer: a retrospective cohort study.

IF 1.2 4区医学 Q3 SURGERY

Annals of Surgical Treatment and Research Pub Date : 2024-06-01 Epub Date: 2024-05-30 DOI:10.4174/astr.2024.106.6.337

Ji Sun Park, Young Suk Kim, Hee Yeon Kim, Yunseon Choi

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引用次数: 0

Abstract

Purpose: We aimed to analyze the occurrence of lymphedema as a side effect in patients who underwent regional nodal irradiation (RNI) following surgery for breast cancer.

Methods: This retrospective study was conducted on patients with breast cancer who underwent surgery from July 2014 to October 2020 at Inje University Busan Paik Hospital. The analysis included 113 cT1-3N1-3M0 breast cancer patients who underwent RNI as part of radiotherapy (RT). Mostly, surgeries were performed using breast-conserving surgery (n = 99, 87.6%), except for 14 patients with modified radical mastectomy. The total RT dose for RNI was 45-60 Gy, and the fraction size was 1.8-2.0 Gy. Most patients underwent chemotherapy (n = 98, 86.7%), including taxanes (n = 92, 81.4%).

Results: The median follow-up was 61.1 months (range, 5.0-110.5 months). Lymphedema occurred in 54 patients (47.8%) after surgery. Twenty of them (17.7%) developed a new onset of lymphedema after RT, while 34 (30.1%) detected lymphedema before the completion of RT. Over the follow-up, 16 patients (14.2%) experienced recurrence. High radiation dose (>50.4 Gy) for RNI (P = 0.003) and taxane use (P = 0.038) were related to lymphedema occurrence after RT. Moreover, lymphedema occurrence after RT was also related to recurrence after surgical resection (P = 0.026). Breast-conserving surgery was related to early-onset lymphedema before the completion of RT (P = 0.047). Furthermore, the degree of lymph node dissection (≤4) was related to the overall occurrence of lymphedema (P = 0.045).

Conclusion: Considering a reduction in RNI dose may be beneficial in mitigating the incidence of lymphedema after RT in patients with breast cancer.

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乳腺癌区域结节照射后的淋巴水肿：一项回顾性队列研究。

目的：我们旨在分析乳腺癌手术后接受区域结节照射（RNI）的患者发生淋巴水肿的副作用：这项回顾性研究以 2014 年 7 月至 2020 年 10 月期间在仁济大学釜山白医院接受手术的乳腺癌患者为对象。分析对象包括113名cT1-3N1-3M0乳腺癌患者，他们在接受放疗（RT）的同时接受了RNI。除 14 名患者接受了改良根治性乳房切除术外，大部分患者都接受了保乳手术（99 人，87.6%）。RNI的总RT剂量为45-60 Gy，分次剂量为1.8-2.0 Gy。大多数患者接受了化疗（98例，86.7%），包括紫杉类药物（92例，81.4%）：中位随访时间为61.1个月（5.0-110.5个月）。54名患者（47.8%）在术后出现了淋巴水肿。其中 20 例（17.7%）在 RT 术后出现新的淋巴水肿，34 例（30.1%）在 RT 术结束前发现淋巴水肿。在随访期间，16 名患者（14.2%）出现复发。RNI的高放射剂量（>50.4 Gy）（P = 0.003）和使用类固醇类药物（P = 0.038）与RT后淋巴水肿的发生有关。此外，RT 后发生淋巴水肿还与手术切除后的复发有关（P = 0.026）。保乳手术与 RT 结束前的早期淋巴水肿有关（P = 0.047）。此外，淋巴结清扫的程度（≤4）与淋巴水肿的总体发生率有关（P = 0.045）：结论：考虑减少 RNI 剂量可能有利于降低乳腺癌患者 RT 术后淋巴水肿的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Surgical Treatment and Research SURGERY-

CiteScore

2.30

自引率

7.10%

发文量

期刊介绍： Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).