Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Focused Guideline Update
Identifieur interne : 000C72 ( Main/Exploration ); précédent : 000C71; suivant : 000C73Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Focused Guideline Update
Auteurs : Abram Recht [États-Unis] ; Elizabeth A. Comen [États-Unis] ; Richard E. Fine [États-Unis] ; Gini F. Fleming [États-Unis] ; Patricia H. Hardenbergh [États-Unis] ; Alice Y. Ho [États-Unis] ; Clifford A. Hudis [États-Unis] ; E. Shelley Hwang [États-Unis] ; Jeffrey J. Kirshner [États-Unis] ; Monica Morrow [États-Unis] ; Kilian E. Salerno [États-Unis] ; George W. Sledge [États-Unis] ; Lawrence J. Solin [États-Unis] ; Patricia A. Spears [États-Unis] ; Timothy J. Whelan [Canada] ; Mark R. Somerfield [États-Unis] ; Stephen B. Edge [États-Unis]Source :
- Annals of Surgical Oncology [ 1068-9265 ] ; 2016.
Abstract
A joint American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology panel convened to develop a focused update of the American Society of Clinical Oncology guideline concerning use of postmastectomy radiotherapy (PMRT).
A recent systematic literature review by Cancer Care Ontario provided the primary evidentiary basis. The joint panel also reviewed targeted literature searches to identify new, potentially practice-changing data.
The panel unanimously agreed that available evidence shows that PMRT reduces the risks of locoregional failure (LRF), any recurrence, and breast cancer mortality for patients with T1-2 breast cancer with one to three positive axillary nodes. However, some subsets of these patients are likely to have such a low risk of LRF that the absolute benefit of PMRT is outweighed by its potential toxicities. In addition, the acceptable ratio of benefit to toxicity varies among patients and physicians. Thus, the decision to recommend PMRT requires a great deal of clinical judgment. The panel agreed clinicians making such recommendations for individual patients should consider factors that may decrease the risk of LRF, attenuate the benefit of reduced breast cancer-specific mortality, and/or increase risk of complications resulting from PMRT. When clinicians and patients elect to omit axillary dissection after a positive sentinel node biopsy, the panel recommends that these patients receive PMRT only if there is already sufficient information to justify its use without needing to know additional axillary nodes are involved. Patients with axillary nodal involvement after neoadjuvant systemic therapy should receive PMRT. The panel recommends treatment generally be administered to both the internal mammary nodes and the supraclavicular-axillary apical nodes in addition to the chest wall or reconstructed breast.
The online version of this article (doi:10.1245/s10434-016-5558-8) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1245/s10434-016-5558-8
PubMed: 27646018
PubMed Central: 5179596
Affiliations:
- Canada, États-Unis
- Californie, Caroline du Nord, Colorado, Illinois, Massachusetts, Ontario, Pennsylvanie, Tennessee, Virginie, État de New York
- Hamilton (Ontario)
- Université McMaster
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Comen</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Memorial Sloan Kettering Cancer Center, New York, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Fine, Richard E" sort="Fine, Richard E" uniqKey="Fine R" first="Richard E." last="Fine">Richard E. Fine</name><affiliation wicri:level="2"><nlm:aff id="Aff3">West Clinic Comprehensive Breast Center, Germantown, TN USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Tennessee</region></placeName><wicri:cityArea>West Clinic Comprehensive Breast Center, Germantown</wicri:cityArea></affiliation></author><author><name sortKey="Fleming, Gini F" sort="Fleming, Gini F" uniqKey="Fleming G" first="Gini F." last="Fleming">Gini F. Fleming</name><affiliation wicri:level="2"><nlm:aff id="Aff4">University of Chicago Medical Center, Chicago, IL USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>University of Chicago Medical Center, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Hardenbergh, Patricia H" sort="Hardenbergh, Patricia H" uniqKey="Hardenbergh P" first="Patricia H." last="Hardenbergh">Patricia H. Hardenbergh</name><affiliation wicri:level="2"><nlm:aff id="Aff5">Shaw Regional Cancer Center, Edwards, CO USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Colorado</region></placeName><wicri:cityArea>Shaw Regional Cancer Center, Edwards</wicri:cityArea></affiliation></author><author><name sortKey="Ho, Alice Y" sort="Ho, Alice Y" uniqKey="Ho A" first="Alice Y." last="Ho">Alice Y. Ho</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Memorial Sloan Kettering Cancer Center, New York, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Hudis, Clifford A" sort="Hudis, Clifford A" uniqKey="Hudis C" first="Clifford A." last="Hudis">Clifford A. Hudis</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Memorial Sloan Kettering Cancer Center, New York, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Hwang, E Shelley" sort="Hwang, E Shelley" uniqKey="Hwang E" first="E. Shelley" last="Hwang">E. Shelley Hwang</name><affiliation wicri:level="2"><nlm:aff id="Aff6">Duke University Medical Center, Durham, NC USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Duke University Medical Center, Durham</wicri:cityArea></affiliation></author><author><name sortKey="Kirshner, Jeffrey J" sort="Kirshner, Jeffrey J" uniqKey="Kirshner J" first="Jeffrey J." last="Kirshner">Jeffrey J. Kirshner</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Hematology Oncology Associates of Central New York, East Syracuse, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Hematology Oncology Associates of Central New York, East Syracuse</wicri:regionArea><wicri:noRegion>East Syracuse</wicri:noRegion></affiliation></author><author><name sortKey="Morrow, Monica" sort="Morrow, Monica" uniqKey="Morrow M" first="Monica" last="Morrow">Monica Morrow</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Memorial Sloan Kettering Cancer Center, New York, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Salerno, Kilian E" sort="Salerno, Kilian E" uniqKey="Salerno K" first="Kilian E." last="Salerno">Kilian E. Salerno</name><affiliation wicri:level="2"><nlm:aff id="Aff8">Roswell Park Cancer Institute, Buffalo, NY USA</nlm:aff><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Roswell Park Cancer Institute, Buffalo</wicri:cityArea></affiliation></author><author><name sortKey="Sledge, George W" sort="Sledge, George W" uniqKey="Sledge G" first="George W." last="Sledge">George W. Sledge</name><affiliation wicri:level="2"><nlm:aff id="Aff9">Stanford University Medical Center, Palo Alto, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Stanford University Medical Center, Palo Alto</wicri:cityArea></affiliation></author><author><name sortKey="Solin, Lawrence J" sort="Solin, Lawrence J" uniqKey="Solin L" first="Lawrence J." last="Solin">Lawrence J. Solin</name><affiliation wicri:level="2"><nlm:aff id="Aff10">Albert Einstein Healthcare Network, Philadelphia, PA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Albert Einstein Healthcare Network, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="Spears, Patricia A" sort="Spears, Patricia A" uniqKey="Spears P" first="Patricia A." last="Spears">Patricia A. Spears</name><affiliation wicri:level="2"><nlm:aff id="Aff11">North Carolina State University, Raleigh, NC USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>North Carolina State University, Raleigh</wicri:cityArea></affiliation></author><author><name sortKey="Whelan, Timothy J" sort="Whelan, Timothy J" uniqKey="Whelan T" first="Timothy J." last="Whelan">Timothy J. Whelan</name><affiliation wicri:level="4"><nlm:aff id="Aff12">Juravinski Cancer Centre, McMaster University, Hamilton, Ontario Canada</nlm:aff><orgName type="university">Université McMaster</orgName><country>Canada</country><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Somerfield, Mark R" sort="Somerfield, Mark R" uniqKey="Somerfield M" first="Mark R." last="Somerfield">Mark R. Somerfield</name><affiliation wicri:level="2"><nlm:aff id="Aff13">American Society of Clinical Oncology, 2318 Mill Road, Suite 800, Alexandria, VA 22314 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Virginie</region></placeName><wicri:cityArea>American Society of Clinical Oncology, 2318 Mill Road, Suite 800, Alexandria</wicri:cityArea></affiliation></author><author><name sortKey="Edge, Stephen B" sort="Edge, Stephen B" uniqKey="Edge S" first="Stephen B." last="Edge">Stephen B. Edge</name><affiliation wicri:level="2"><nlm:aff id="Aff8">Roswell Park Cancer Institute, Buffalo, NY USA</nlm:aff><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Roswell Park Cancer Institute, Buffalo</wicri:cityArea></affiliation></author></analytic><series><title level="j">Annals of Surgical Oncology</title><idno type="ISSN">1068-9265</idno><idno type="eISSN">1534-4681</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>A joint American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology panel convened to develop a focused update of the American Society of Clinical Oncology guideline concerning use of postmastectomy radiotherapy (PMRT).</p></sec><sec><title>Methods</title><p>A recent systematic literature review by Cancer Care Ontario provided the primary evidentiary basis. The joint panel also reviewed targeted literature searches to identify new, potentially practice-changing data.</p></sec><sec><title>Recommendations</title><p>The panel unanimously agreed that available evidence shows that PMRT reduces the risks of locoregional failure (LRF), any recurrence, and breast cancer mortality for patients with T1-2 breast cancer with one to three positive axillary nodes. However, some subsets of these patients are likely to have such a low risk of LRF that the absolute benefit of PMRT is outweighed by its potential toxicities. In addition, the acceptable ratio of benefit to toxicity varies among patients and physicians. Thus, the decision to recommend PMRT requires a great deal of clinical judgment. The panel agreed clinicians making such recommendations for individual patients should consider factors that may decrease the risk of LRF, attenuate the benefit of reduced breast cancer-specific mortality, and/or increase risk of complications resulting from PMRT. When clinicians and patients elect to omit axillary dissection after a positive sentinel node biopsy, the panel recommends that these patients receive PMRT only if there is already sufficient information to justify its use without needing to know additional axillary nodes are involved. Patients with axillary nodal involvement after neoadjuvant systemic therapy should receive PMRT. The panel recommends treatment generally be administered to both the internal mammary nodes and the supraclavicular-axillary apical nodes in addition to the chest wall or reconstructed breast.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1245/s10434-016-5558-8) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Recht, A" uniqKey="Recht A">A Recht</name></author><author><name sortKey="Edge, Sb" uniqKey="Edge S">SB Edge</name></author><author><name sortKey="Solin, Lj" uniqKey="Solin L">LJ Solin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tseng, Yd" uniqKey="Tseng Y">YD Tseng</name></author><author><name sortKey="Uno, H" uniqKey="Uno H">H Uno</name></author><author><name sortKey="Hughes, Me" uniqKey="Hughes M">ME 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Nord</li><li>Colorado</li><li>Illinois</li><li>Massachusetts</li><li>Ontario</li><li>Pennsylvanie</li><li>Tennessee</li><li>Virginie</li><li>État de New York</li></region><settlement><li>Hamilton (Ontario)</li></settlement><orgName><li>Université McMaster</li></orgName></list><tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Recht, Abram" sort="Recht, Abram" uniqKey="Recht A" first="Abram" last="Recht">Abram Recht</name></region><name sortKey="Comen, Elizabeth A" sort="Comen, Elizabeth A" uniqKey="Comen E" first="Elizabeth A." last="Comen">Elizabeth A. Comen</name><name sortKey="Edge, Stephen B" sort="Edge, Stephen B" uniqKey="Edge S" first="Stephen B." last="Edge">Stephen B. Edge</name><name sortKey="Fine, Richard E" sort="Fine, Richard E" uniqKey="Fine R" first="Richard E." last="Fine">Richard E. Fine</name><name sortKey="Fleming, Gini F" sort="Fleming, Gini F" uniqKey="Fleming G" first="Gini F." last="Fleming">Gini F. Fleming</name><name sortKey="Hardenbergh, Patricia H" sort="Hardenbergh, Patricia H" uniqKey="Hardenbergh P" first="Patricia H." last="Hardenbergh">Patricia H. Hardenbergh</name><name sortKey="Ho, Alice Y" sort="Ho, Alice Y" uniqKey="Ho A" first="Alice Y." last="Ho">Alice Y. Ho</name><name sortKey="Hudis, Clifford A" sort="Hudis, Clifford A" uniqKey="Hudis C" first="Clifford A." last="Hudis">Clifford A. Hudis</name><name sortKey="Hwang, E Shelley" sort="Hwang, E Shelley" uniqKey="Hwang E" first="E. Shelley" last="Hwang">E. Shelley Hwang</name><name sortKey="Kirshner, Jeffrey J" sort="Kirshner, Jeffrey J" uniqKey="Kirshner J" first="Jeffrey J." last="Kirshner">Jeffrey J. Kirshner</name><name sortKey="Morrow, Monica" sort="Morrow, Monica" uniqKey="Morrow M" first="Monica" last="Morrow">Monica Morrow</name><name sortKey="Salerno, Kilian E" sort="Salerno, Kilian E" uniqKey="Salerno K" first="Kilian E." last="Salerno">Kilian E. Salerno</name><name sortKey="Sledge, George W" sort="Sledge, George W" uniqKey="Sledge G" first="George W." last="Sledge">George W. Sledge</name><name sortKey="Solin, Lawrence J" sort="Solin, Lawrence J" uniqKey="Solin L" first="Lawrence J." last="Solin">Lawrence J. Solin</name><name sortKey="Somerfield, Mark R" sort="Somerfield, Mark R" uniqKey="Somerfield M" first="Mark R." last="Somerfield">Mark R. Somerfield</name><name sortKey="Spears, Patricia A" sort="Spears, Patricia A" uniqKey="Spears P" first="Patricia A." last="Spears">Patricia A. Spears</name></country><country name="Canada"><region name="Ontario"><name sortKey="Whelan, Timothy J" sort="Whelan, Timothy J" uniqKey="Whelan T" first="Timothy J." last="Whelan">Timothy J. Whelan</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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