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• W2800505588 abstract "Management of the axilla has undergone a tremendous evolution in recent years. Although surgery has become progressively less invasive, data supporting a larger role and extent of regional nodal irradiation (RNI) have grown. For example, the AMAROS trial (After Mapping of the Axilla Radiation or Surgery) demonstrated that axillary radiation therapy (AXL-RT) can be used as an alternative to completion axillary lymph node dissection (cALND) in node-positive patients, yielding extremely low rates of axillary recurrence and less morbidity than surgical resection ( 1 Donker M. van Tienhoven G. Straver M.E. et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): A randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014; 15: 1303-1310 Abstract Full Text Full Text PDF PubMed Scopus (1059) Google Scholar ). Simultaneously, MA.20 and European Organization for Research and Treatment of Cancer (EORTC) trial 2292 reported improvements in disease-free survival (DFS) and distant metastasis-free survival in patients with node-positive, high-risk node-negative, or central/medial tumors RNI ( 2 Poortmans P.M. Struikmans H. Bartelink H. Regional nodal irradiation in early-stage breast cancer. N Engl J Med. 2015; 373: 1879-1880 Crossref PubMed Scopus (715) Google Scholar , 3 Whelan T.J. Olivotto I.A. Levine M.N. Regional nodal irradiation in early-stage breast cancer. N Engl J Med. 2015; 373: 1878-1879 Crossref PubMed Scopus (605) Google Scholar ). Nevertheless, concurrent surgical trials evaluating the omission of ALND in the absence of consistent regional nodal radiation also reported excellent long-term outcomes ( 4 Giuliano A.E. Hunt K.K. Ballman K.V. et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: A randomized clinical trial. JAMA. 2011; 305: 569-575 Crossref PubMed Scopus (2248) Google Scholar ). Similarly, it is not clear that the value of RNI applies equally to all patient subsets. For example, in a planned subset analysis of MA.20, estrogen receptor–positive patients seem to derive a lesser benefit from RNI than their estrogen receptor–negative counterparts. Conversely, in the EORTC trial showing improved outcomes with RNI, a full 44% of the patient cohort had high-risk node-negative disease. This confluence of data suggests that many unresolved issues remain in the optimal prescription of RNI. In this Oncology Scan we highlight some recent reports on this topic that aim to validate the efficacy of AXL-RT as a single modality, enhance the convenience of treatment delivery, and improve patient selection." @default.
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• W2800505588 date "2018-06-01" @default.
• W2800505588 modified "2023-09-27" @default.
• W2800505588 title "Regional Nodal Irradiation in the Modern Era of Breast Cancer Management" @default.
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• W2800505588 doi "https://doi.org/10.1016/j.ijrobp.2017.10.036" @default.
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