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Individual case review in a phase 3 randomized trial to investigate the role of internal mammary lymph node irradiation for breast cancer: Korean Radiation Oncology Group 08-06 study

 Hong In Yoon  ;  Jeongmin Yoon  ;  Yoonsun Chung  ;  Chung Mo Nam  ;  Hyejung Cha  ;  Jinhyun Choi  ;  Jeongshim Lee  ;  Hee Ji Han  ;  Yeona Cho  ;  Yong Bae Kim  ;  Chang-Ok Suh 
 RADIOTHERAPY AND ONCOLOGY, Vol.123(1) : 15-21, 2017 
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Adult ; Aged ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery* ; Female ; Humans ; Lymph Nodes/pathology ; Lymph Nodes/radiation effects* ; Lymphatic Irradiation/methods* ; Mastectomy* ; Mastectomy, Segmental ; Radiotherapy Dosage ; Radiotherapy, Adjuvant ; Survival Analysis ; Treatment Outcome
Individual cases review ; Internal mammary node irradiation ; Protocol-compliance ; Radiation therapy quality assurance
PURPOSE/OBJECTIVE: This study aimed to assess protocol compliance based on an individual case review (ICR) of the Korean Radiation Oncology Group-0806 trial. METHODS AND MATERIALS: For the ICR, 747 participants were divided into eight subgroups based on internal mammary node irradiation (IMNI), tumor laterality, and surgery type. Next, 15% of patients were randomly selected within each subgroup, and corresponding hospitals were subsequently requested to upload information related to radiation therapy (RT) planning. We reviewed the dose distributions of targets and organs at risk to determine protocol compliance. RESULTS: Data of 102 patients were collected. Overall, RT plans were found to be mostly protocol-compliant, with acceptability rates of 60-80% despite deviations in the ipsilateral lung in Arm 2 (IMNI group). However, despite few deviations, a subgroup analysis revealed significant differences in protocol compliance. Among RT techniques, plans using standard and partial wide tangents were most compliant in both Arms. In this ICR, the estimated survival benefits based on IMN doses were 7.7%, 8.4%, and 7.2% for all, breast-conserving surgery, and mastectomy cases, respectively. CONCLUSION: This ICR demonstrated overall protocol compliance, despite significant differences with regard to IMN irradiation and organs at risk according to subgroups and adopted field arrangements.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Nam, Jung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Suh, Chang Ok(서창옥)
Yoon, Jeongmin(윤정민)
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Lee, Jeong Shim(이정심)
Cho, Yeona(조연아) ORCID logo https://orcid.org/0000-0002-1202-0880
Choi, Jinhyun(최진현)
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