Akademik Veri Yönetim Sistemi
Journal of B.U.ON., cilt.6, sa.3, ss.255-261, 2001 (Scopus)
Purpose: To analyse prognostic factors and survival of breast cancer patients treated with post-mastectomy adjuvant radiotherapy (RT). Patients and methods: Included were 820 breast cancer patients treated with mastectomy and axillary lymph node dissection in the years 1978-1997. There were 47 (6%) patients with tumor (T) T3-4 stage without lymph node (N) involvement (pT3-4N0M0), and 773 (94%) patients with any tumor stage and with axillary lymph node involvement (pTx,1,2,3,4N1-2M0). Their median age was 48 years (range 21-85 years). All of the patients received chest wall and regional nodal RT with Cobalt 60. A total dose of 50 Gy (range 46-54 Gy) was given in 2 Gy daily fractions, 5 times weekly. One hundred and forty (17%) patients did not receive adjuvant medical treatment. Two hundred and fifty-five (31%) patients received adjuvant tamoxifen and 425 (52%) patients received adjuvant chemotherapy. At the time of analysis the median follow-up time was 62 months (range 24-235 months). Results: The 5 and 10-year locoregional control rates were 86% and 79%, respectively. Disease-free survival (DFS) rates were 57% and 42%, disease-specific survival (DSS) rates were 69% and 47% for 5 and 10 years, respectively. T stage (p=0.0016), nodal status (p=0.0000) and grade (p=0.0038) were independent prognostic factors affecting the locoregional control in multivariate analysis according to the Cox model. Age (p=0.0000), adjuvant treatment (p=0.0052), T stage (p=0.0002), and nodal status (p=0.0000) were independent prognostic factors for DFS. Age (p=0.012), T stage (p=0.001), and nodal status (p=0.0000) were independent factors for DSS. Conclusion: Our results indicate that T stage and nodal status are independent prognostic factors for both locoregional control and survival, and patients with high T stage or with nodal involvement will benefit from postoperative RT.