The value of adjuvant radiotherapy on survival and recurrence in triple-negative breast cancer: a systematic review and meta-analysis of 5,507 patients

BACKGROUND: The value of adjuvant radiotherapy in triple negative breast cancer (TNBC) remains unclear. A systematic review and meta-analysis was conducted in TNBC patients to assess survival and recurrence outcomes associated with radiotherapy following either breast conserving therapy (BCT) or post-mastectomy radiotherapy (PMRT). METHODS: Four electronic databases were searched from January 2000 to November 2015 (PubMed, MEDLINE, EMBASE and Web of Science). Studies investigating overall survival and/or recurrence in TNBC patients according to radiotherapy administration were included. A random effects meta-analysis was conducted using mastectomy only patients as the reference.  RESULTS: Twelve studies were included. The pooled hazard ratio (HR) for locoregional recurrence comparing BCT and PMRT to mastectomy only was 0.61 (95% confidence interval [CI] 0.41-0.90) and 0.62 (95% CI 0.44-0.86), respectively. Adjuvant radiotherapy was not significantly associated with distant recurrence. The pooled HR for overall survival comparing BCT and PMRT to mastectomy only was 0.57 (95% CI 0.36-0.88) and HR 1.12 (95% CI 0.75, 1.69). Comparing PMRT to mastectomy only, tests for interaction were not significant for stage (p=0.98) or age at diagnosis (p=0.85). However, overall survival was improved in patients with late-stage disease (T3-4, N2-3) pooled HR 0.53 (95% CI 0.32-0.86), and women <40 years, pooled HR 0.30 (95% CI 0.11-0.82). CONCLUSIONS: Adjuvant radiotherapy was associated with a significantly lower risk of locoregional recurrence in TNBC patients, irrespective of the type of surgery. While radiotherapy was not consistently associated with an overall survival gain, benefits may be obtained in women with late-stage disease and younger patients. 

The tariff. Speech of Representative J. L. McLaurin, of South Carolina, in the House of Representatives, Tuesday, March 23, 1897

This document contains a speech of John L. McLaurin, representative of South Carolina, in the House of Representatives on Tuesday, March 23, 1897 about proposed tariffs.

Curso EFA de Técnico de Contabilidade : a relevância da aprendizagem inserida numa vida laboral activa : Unidade Didáctica : UFCD, Unidade 23, 6218 Gastos de produção

Relatório da Prática de Ensino Supervisionada, Mestrado em Ensino de Economia e Contabilidade, Universidade de Lisboa, 2011

Second Annual Spring Collegiate Jazz Festival, May 23, 1976

Concert program for Second Annual Spring Collegiate Jazz Festival, May 23, 1976

The Studio Jazz Ensemble, The Western Washington State University Workshop Band, The University of Washington Contemporary Group Jazz Ensemble November 23, 1977

Concert program for Studio Jazz Ensemble, Western Washington State University Workshop Band, The University of Washington Contemporary Group Jazz EnsembleNovember 23, 1977

Faculty Recital, Friends of Opera benefit, January 23, 2001

Concert program for Faculty Recital, Friends of Opera benefit, January 23, 2001

Golden Lion, January 23, 25, and 26, 1963

Concert program for Golden Lion, January 23, 25, and 26, 1963