![]() Based on these evidences, it is recommended that patients with pathologically stage III disease after primary breast surgery, as well as those with pathologically positive lymph nodes following neoadjuvant systemic therapy and breast surgery, should receive postoperative breast/chest wall and regional nodal irradiation (RNI). Additionally, patients with pathologically positive lymph node after neoadjuvant chemotherapy and surgery have been shown to have high risk of recurrence and could benefit from postoperative radiotherapy. Numerous randomized clinical trials and meta-analyses have demonstrated that radiotherapy significantly reduces local-regional recurrence and improves disease-free survival and breast cancer-specific survival in high-risk breast cancer patients after primary breast surgery. Trial registrationĬ Identifier: NCT05059379. The results of the SUCLANODE trial will provide high-level evidence regarding whether adding posterolateral SCL irradiation to medial SCL target volume provides survival benefit in patients with high-risk breast cancer. The target sample size is 1650 participants. The primary end point is invasive disease-free survival, and secondary end points included overall survival, SCL recurrence, local-regional recurrence, distance recurrence, safety outcome, and patient-reported outcomes. Both hypofractionated and conventional fractionation schedules are permitted. Advanced intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), or tomotherapy techniques are recommended. Other radiation volumes are identical in the two arms, including breast/chest wall, undissected axillary lymph node, and internal mammary node. Stratification is by chemotherapy sequence (neoadjuvant vs. Patients with pathological N2-3b disease following initial surgery, or clinical stage III or pathological N1-3b if receiving neoadjuvant systemic therapy, are eligible and randomly assigned (1:1) to M-SCLI group and E-SCLI group. The SUCLANODE trial is an open-label, multicenter, randomized, phase 3 trial comparing the efficacy and adverse events of medial SCL irradiation (M-SCLI group) and medial plus posterolateral SCL irradiation (entire SCL irradiation, E-SCLI group) in high-risk breast cancer patients who underwent breast conserving-surgery or mastectomy. ![]() Nevertheless, it remains uncertain whether adding the posterolateral SCL irradiation improves survival outcomes for high-risk breast cancer patients. Consequently, many radiation oncologists advocate for enlarging the SCL irradiation target volume to include both the medial and posterolateral SCL regions. ![]() However, recent studies have found that a substantial proportion of SCL failures are located in the posterolateral SCL region, outside of the RTOG/ESTRO-defined SCL target volumes. The Radiation Therapy Oncology Group (RTOG) and European Society for Radiotherapy and Oncology (ESTRO) breast contouring atlases delineate the medial part of the SCL region, while excluding the posterolateral part. Supraclavicular nodal (SCL) irradiation is commonly used for patients with high-risk breast cancer after breast surgery.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |