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. 2018 Jul;194(7):607-618.
doi: 10.1007/s00066-018-1270-x. Epub 2018 Jan 30.

Individualization of post-mastectomy radiotherapy and regional nodal irradiation based on treatment response after neoadjuvant chemotherapy for breast cancer : A systematic review

David Krug  1   2 , René Baumann  3 , Wilfried Budach  4 , Jürgen Dunst  3 , Petra Feyer  5 , Rainer Fietkau  6 , Wulf Haase  7 , Wolfgang Harms  8 , Thomas Hehr  9 , Marc D Piroth  10 , Felix Sedlmayer  11 , Rainer Souchon  12 , Frederik Wenz  13 , Rolf Sauer  6
Affiliations

Individualization of post-mastectomy radiotherapy and regional nodal irradiation based on treatment response after neoadjuvant chemotherapy for breast cancer : A systematic review

David Krug et al. Strahlenther Onkol. 2018 Jul.

Abstract

Purpose: To review the evidence regarding post-mastectomy radiotherapy (PMRT) and regional nodal irradiation (RNI) after neoadjuvant chemotherapy (NACT) for breast cancer, with a special focus on individualization of adjuvant radiotherapy based on treatment response.

Methods: A systematic literature search using the PubMed/Medline database was performed. We included prospective and retrospective reports with a minimum of 10 patients that had been published since 1st January 2000, and provided clinical outcome data analyzed by treatment response and radiotherapy.

Results: Out of 763 articles identified via PubMed/Medline and hand search, 68 full text-articles were assessed for eligibility after screening of title and abstract. 13 studies were included in the systematic review, 9 for PMRT and 5 for RNI. All included studies were retrospective reports.

Conclusions: There is a considerable lack of evidence regarding the role of adjuvant radiotherapy and its individualization based on treatment response after NACT. Results of prospective randomized trials such as NSABP B‑51/RTOG 1304 and Alliance A11202 are eagerly awaited.

Keywords: Breast neoplasms; Local recurrence; Neoadjuvant therapy; Radiotherapy.

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