Decomposition-Reassembly Synthesis of a Silverton-Type Polyoxometalate 3D Framework: Semiconducting Properties and Photocatalytic Applications.

Polyoxometalate-based all-inorganic three-dimensional (3D) frameworks have recently attracted attention as a unique class of materials due to their unique physicochemical properties and a wide field of application with excellent prospects. We herein synthesized a novel all-inorganic 3D framework material based on cobalt-substituted Silverton-type polyoxometalate, H6{Co6W10O42[Co(H2O)4]3}·2H2O (Co9W10), which was successfully constructed using Na12[WCo3II(H2O)2(CoIIW9O34)2]·46-48H2O (Co5W19) and Co(NO3)2·6H2O as starting materials in a hydrothermal reaction via a decomposition-reassembly route together with the rational adjustment of pH values. Co9W10 has been structurally characterized using single-crystal X-ray diffraction. Photocurrent response, band-gap (Eg) value, and the VB-XPS spectrum have been measured to reveal the semiconducting property of Co9W10. Furthermore, we synthesized x% PTh/Co9W10 composites (PTh = polythiophene, x = 0.5, 1, 2, 5) for photodegradation of tetracycline hydrochloride (TH) to evaluate the photocatalytic activities of title composites. Due to the optimal molar ratio of hybrids and matching energy levels, 2% PTh/Co9W10 composites show the best photocatalytic activities among these composites.

Exploring the Coordination Modes of a Keggin-Type [ZnW12O40]6- Anionic Cluster: Bonding Patterns, Crystal Structure, and Semiconducting Properties.

Polyoxometalate-based organic-inorganic hybrid compounds (POIHCs) have been greatly developed due to their wide application prospects, but the pursuit of their directed synthesis via molecular design still remains a challenge. Herein, we demonstrate that the coordination modes of the Keggin-type [ZnW12O40]6- anion can be tuned, which leads to different semiconductor characteristics. Using the same building block, ligand, and metal ion (ZnW12, phen, Cu2+), we synthesized three new POIHCs with different bonding patterns by means of different coordination modes of ZnW12. The three POIHCs (H2phen){ZnW12O40[Cu(phen)2]2}·3H2O (1), {ZnW12O40[Cu(phen)(H2O)2]2[Cu(phen)(H2O)]}n·3H2O (2), and (Me4N)2{ZnW12O40[Cu(phen)(H2O)]2}n·5H2O (3) (phen = 1,10-phenanthroline) have been structurally characterized by single-crystal X-ray diffraction. Compound 1 appears as a zero-dimensional coordination complex cluster, while compounds 2 and 3 are both 1D chain structures with different Cu2+ bridge linkages. Although these three POIHCs possess the same chemical components, their semiconductor properties are different, which is demonstrated by measurements of transient photocurrent and band gap (Eg) values. Furthermore, we carried out comparative experiments on the photoconductivity performance of compounds 1-3 and their photocatalytic reduction from O2 to H2O2, indicating the significant influence of the energy level matching on the photocatalytic activity.

Histological Tumor Type is Associated with One-Year Cause-Specific Survival in Women with Stage III-IV Epithelial Ovarian Cancer: A Surveillance, Epidemiology, and End Results (SEER) Database Population Study, 2004-2014.

BACKGROUND The prognosis of epithelial ovarian cancer (EOC) remains poor. Cause-specific survival (CSS) is an overall survival measure of cancer survival that excludes other causes of death. This retrospective population study used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate prognostic factors associated with one-year CSS in women with stage III-IV EOC between 2004-2014. MATERIAL AND METHODS Data from the SEER program included a cohort of patients with stage III-IV EOC between 2004-2014. Binomial logistic regression analysis, Kaplan-Meier survival curves, and multivariate Cox proportional hazards models were used for analysis of patient outcome, including the one-year CSS. RESULTS There were 14,798 patients with stage III-IV EOC identified from SEER between 2004-2014, including 13,134 (88.8%), 892 (6.0%), 448 (3.0%), and 324 (2.2%) patients with serous, endometrioid, clear cell, and mucinous ovarian cancer, respectively. The overall one-year CSS was 91.2%. One-year CSS was 92.5%, 92.2%, 74.0%, and 62.5% in patients with serous, endometrioid, clear cell, and mucinous ovarian cancer, respectively (P<0.001). Histological tumor type was an independent prognostic factor of one-year CSS. Patients with mucinous EOC (HR, 8.807; 95% CI, 6.563-9.965; P<0.001) and clear cell EOC (HR, 4.581; 95% CI, 3.774-5.560; P<0.001) had a significantly lower one-year CSS compared with patients with endometrioid and serous EOC who had comparable one-year CSS (HR, 1.247; 95% CI, 0.978-1.590; P=0.075). CONCLUSIONS A retrospective population study of the SEER database between 2004-2014 identified that histological tumor type was associated with one-year CSS in women with stage III-IV EOC.

Tubular carcinomas of the breast: an epidemiologic study.

AIM: We explored the clinicopathologic characteristics, prognostic factors and outcomes in tubular carcinoma (TC) of the breast. METHODS: We retrospectively assessed 8091 TC patients using the SEER database from 2000 to 2013. RESULTS: Most patients were non-Hispanic white, well-differentiated disease, tumor size ≤2 cm, node-negative, nonmetastatic, hormone receptor-positive and HER2-negative status. The 10-year breast cancer-specific survival and overall survival were 98.1 and 82.0%, respectively. Multivariate analysis indicated that age, ethnicity, surgery procedures, radiotherapy and chemotherapy were independent predictors affecting survival outcomes. There was comparable breast cancer-specific survival between surgery and nonsurgery groups. CONCLUSION: The patients with TC has excellent survival outcomes, which may in part be due to the favorable tumor characteristics.

Lymph node ratio has prognostic value related to the number of positive lymph nodes in patients with vulvar cancer.

AIM: We investigated the value of the number of positive lymph nodes (PLNs) and lymph node ratio (LNR) on survival of vulvar cancer patients. METHODS: A total of 2332 patients with vulvar squamous cell carcinoma were included from the SEER program. RESULTS: In multivariate analysis, the number of PLNs and LNR were independent prognostic indictors of survival outcomes, a higher number of PLNs and a higher LNR had poorer survival outcomes. An LNR >0.2 was associated with poor survival outcomes according to the number of PLNs. CONCLUSION: The LNR has prognostic value related to the number of PLNs and may allow a more accurate determination of the lymph node status of vulvar cancer patients.

Widowed status increases the risk of death in vulvar cancer.

AIM: To evaluate the effect of marital status on survival of patients with vulvar cancer. MATERIALS & METHODS: A total of 4001 patients with vulvar cancer were included from the SEER database. Statistical analyses were performed using χ2 test, Kaplan-Meier method, Cox regression proportional hazards and a 1:1 propensity score-matching. RESULTS: The 8-year vulvar cancer-related survival in married, divorced, single and widowed patients were 78.6, 82.2, 78.9 and 61.6%, respectively (p < 0.001). In multivariate analysis, widows patients had significantly worse vulvar cancer survival than the nonwidowed counterparts in unmatched and matched populations. CONCLUSION: Being widowed is associated with greater risk of vulvar cancer mortality than the nonwidowed counterparts.

The effect of distant metastases sites on survival in de novo stage-IV breast cancer: A SEER database analysis.

To investigate the effect of distant metastases sites on survival in patients with de novo stage-IV breast cancer. From 2010 to 2013, patients with a diagnosis of de novo stage-IV breast cancer were identified using the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression analyses were performed to analyze the effect of distant metastases sites on breast cancer-specific survival and overall survival. A total of 7575 patients were identified. The most common metastatic sites were bone, followed by lung, liver, and brain. Patients with hormone receptor+/human epidermal growth factor receptor 2- and hormone receptor+/human epidermal growth factor receptor 2+ status were more prone to bone metastases. Lung and brain metastases were common in hormone receptor-/human epidermal growth factor receptor 2+ and hormone receptor-/human epidermal growth factor receptor 2- subtypes, and patients with hormone receptor+/ human epidermal growth factor receptor 2+ and hormone receptor-/human epidermal growth factor receptor 2+ subtypes were more prone to liver metastases. Patients with liver and brain metastases had unfavorable prognosis for breast cancer-specific survival and overall survival, whereas bone and lung metastases had no effect on patient survival in multivariate analyses. The hormone receptor-/human epidermal growth factor receptor 2- subtype conferred a significantly poorer outcome in terms of breast cancer-specific survival and overall survival. hormone receptor+/human epidermal growth factor receptor 2+ disease was associated with the best prognosis in terms of breast cancer-specific survival and overall survival. Patients with liver and brain metastases were more likely to experience poor prognosis for breast cancer-specific survival and overall survival by various breast cancer subtypes. Distant metastases sites have differential impact on clinical outcomes in stage-IV breast cancer. Follow-up screening for brain and liver metastases might be effective in improving breast cancer-specific survival and overall survival.

Number of negative lymph nodes is associated with disease-free survival in patients with breast cancer.

BACKGROUND: The aim of this study was to evaluate the prognostic value of the number of negative lymph nodes (NLNs) in breast cancer patients after mastectomy. METHODS: 2,455 breast cancer patients who received a mastectomy between January 1998 and December 2007 were retrospectively reviewed. The prognostic impact of the number of NLNs with respect to disease-free survival (DFS) was analyzed. RESULTS: The median follow-up time was 62.0 months, and the 5-year and 10-year DFS was 87.1% and 74.3%, respectively. The DFS of patients with >10 NLNs was significantly higher than that of patents with ≤10 NLNs, and the 5-year DFS rates were 87.5% and 69.5%, respectively (P < 0.001). Univariate Cox analysis showed that the NLN count (continuous variable) was a prognostic factor of DFS (hazard ratio [HR] = 0.913, 95% confidence interval [CI]: 0.896-0.930, P < 0.001). In multivariate Cox analysis, patients with a higher number of NLNs had a better DFS (HR = 0.977, 95% CI: 0.958-0.997, P = 0.022). Subgroup analysis showed that the NLN count had a prognostic value in patients at different pT stages and pN positive patients (log-rank P < 0.001). However, it had no prognostic value in pN0 patients (log-rank P = 0.684). CONCLUSIONS: The number of NLNs is an independent prognostic factor of DFS in breast cancer patients after mastectomy, and patients with a higher number of NLNs have a better DFS.

Locoregional recurrence of pT3N0M0 breast cancer after mastectomy is not higher than that of pT1-2N0M0: an analysis for radiotherapy.

The purpose of this study was to investigate the value of post-operative radiotherapy in the treatment of pT3N0M0 breast cancer after mastectomy. We analyzed the clinical data of 1390 patients with pT1-3N0M0 breast cancer who were admitted and treated from 1998 to 2007 at the Sun Yat-sen University Cancer Center. All patients underwent mastectomy and did not receive radiotherapy. The locoregional recurrence-free survival, distant metastasis-free survival and overall survival of different T stages of breast cancer were compared. The median follow-up duration was 72 months. The 10-year locoregional recurrence-free survival patients with pT1N0, pT2N0 and pT3N0 breast cancers were 95.3, 91.9 and 93.6%, respectively (χ(2) = 2.550, P = 0.279). The 10-year distant metastasis-free survival rates of patients with pT1N0, pT2N0 and pT3N0 breast cancers were 88.1%, 81.0% and 78.4%, respectively (χ(2) = 8.254, P = 0.016). The 10-year overall survival rates of patients with pT1N0, pT2N0 and pT3N0 breast cancers were 91.9%, 83.5% and 73.0%, respectively (χ(2) = 12.403, P = 0.002). Univariate analyses failed to identify any prognostic factors for locoregional recurrence in pT3N0 patients. Multivariate analysis showed that the T stage had no effect on locoregional recurrence. The locoregional recurrence rate in patients with pT3N0M0 breast cancer who underwent mastectomy and did not receive postoperative radiotherapy was not higher than that in patients with pT1-2N0M0 breast cancer who received the same treatment, suggesting that routine adjuvant post-operative radiotherapy should not be recommended in this patient population.

A comparison of quality of life of early breast cancer patients treated with accelerated partial breast irradiation versus whole breast irradiation in China.

To compare quality of life (QoL) of early breast cancer patients treated with either accelerated partial breast irradiation (APBI) or whole breast irradiation (WBI) after breast-conserving therapy in China. The functional assessment of chronic illness therapy-Breast, traditional Chinese version 4 (FACT-B) instruments were given to 84 women (31 APBI and 53 WBI) who attended the radiotherapy clinic between July 2006 and May 2009 at Cancer Center of Sun Yat-sen University. Baseline characteristics and Karnofsky performance status scores were not different between the two groups. The median follow-up period in the APBI group was 29 versus 34 months in the WBI group. The APBI group scores in the physical domain, functional domain, social domain, and breast-specific concerns of FACT-B were 23.01 ± 3.91, 17.97 ± 4.99, 20.87 ± 4.80, and 22.55 ± 5.45, respectively, and were not significantly different from those of the WBI group (22.80 ± 3.50, 17.50 ± 4.40, 20.13 ± 5.31, 23.81 ± 4.65, respectively, P = 0.987, P = 0.476, P = 0.442, P = 0.330, respectively). However, the scores of the APBI group with respect to the emotional domains were lower compared to those of the WBI group (16.84 ± 3.86 vs. 19.47 ± 3.45, respectively, P = 0.002). Compared with women who underwent WBI, women treated with APBI were shown to have no significantly better QoL outcome, and yet had worse emotional response to their treatment.

Controllable self-assembly of organic-inorganic amphiphiles containing Dawson polyoxometalate clusters.

An organic-inorganic molecular hybrid containing the Dawson polyoxometalate, ((C(4)H(9))(4)N)(5)H[P(2)V(3)W(15)O(59)(OCH(2))(3)CNHCOC(15)H(31)], was synthesized and its surfactant-like amphiphilic properties, represented by the formation of bilayer vesicles, were studied in polar solvents. The vesicle size decreases with both decreasing hybrid concentration and with increasing polarity of the solvent, independently. The self-assembly behavior of this hybrid can be controlled by introducing different counterions into the acetonitrile solutions. The addition of ZnCl(2) and NaI can cause a gradual decrease and increase of vesicular sizes, respectively. Tetraalkylammonium bromide is found to disassemble the vesicle assemblies. Moreover, the original counterions of the hybrid can be replaced with protons, resulting in pH-dependent formation of vesicles in aqueous solutions. The hybrid surfactant can further form micro-needle structures in aqueous solutions upon addition of Ca(2+) ions.

Design and synthesis of "dumb-bell" and "triangular" inorganic-organic hybrid nanopolyoxometalate clusters and their characterisation through ESI-MS analyses.

A series of tris(hydroxymethyl)aminomethane (TRIS)-based linear (bis(TRIS)) and triangular (tris(TRIS)) ligands has been synthesised and were covalently attached to the Wells-Dawson type cluster [P(2)V(3)W(15)O(62)](9-) to generate a series of nanometer-sized inorganic-organic hybrid polyoxometalate clusters. These huge hybrids, with a molecular mass similar to that of small proteins in the range of ≈10-16 kDa, were unambiguously characterised by using high-resolution ESI-MS. The ESI-MS spectra of these compounds revealed, in negative ion mode, a characteristic pattern showing distinct groups of peaks corresponding to different anionic charge states ranging from 3(-) to 8(-) for the hybrids. Each peak in these individual groups could be unambiguously assigned to the corresponding hybrid cluster anion with varying combinations of tetrabutylammonium (TBA) and other cations. This study therefore highlights the prowess of the high-resolution ESI-MS for the unambiguous characterisation of large, nanoscale, inorganic-organic hybrid clusters that have huge mass, of the order of 10-16 kDa. Also, the designed synthesis of these compounds points to the fact that we were able to achieve a great deal of structural pre-design in the synthesis of these inorganic-organic hybrid polyoxometalates (POMs) by means of a ligand design route, which is often not possible in traditional "one-pot" POM synthesis.

Amphiphilic properties of dumbbell-shaped inorganic-organic-inorganic molecular hybrid materials in solution and at an interface.

Five novel dumbbell-shaped polyoxometalate (POM)-based inorganic-organic-inorganic molecular hybrids are investigated both in polar solvents and at interfaces for potential amphiphilic properties, which are compared with those of conventional surfactants. These hybrids with the general formula {P(2)V(3)W(15)}(2)-bis(TRIS)-linker are formed by linking two Wells-Dawson-type clusters, [P(2)V(3)W(15)O(62)](9-), with different linear bis(TRIS) linker ligands between the two TRIS moieties. Laser light scattering (LLS) studies reveal the presence of self-assembled vesicular structures in water/acetone mixed solvents, and the vesicle size increases with increasing acetone content, suggesting a charge-regulated process. The elastic constants, which are used to calculate the bending energy during vesicle formation, reveal that the organic ligands play an important role in determining the self-assembly process and that the hybrids do demonstrate amphiphilic behavior at the water/air interface. Furthermore, it is shown that some of the hybrids form monolayers at the interface, with an average molecular area that can be correlated with their organic linkers, as determined from their π-A isotherms. Finally, the hybrids not only display amphiphilic behavior akin to that of a surfactant but also exhibit an unusually high entropy contribution to vesicle formation as a result of their unique large, polar head groups, complex organic linkers, and their special molecular architectures as well as because of the involvement of the amphiphilic tetrabutylammonium (TBA) counterions.

[Mn(C4H10ON)(H2O)][Fe(CN)6]: a three-dimensional cyanide-bridged ferrimagnet with a morpholine ligand.

The reaction of the Mn(II) and [Fe(CN)(6)](3-) ions in the presence of morpholine at 90 °C yields a new cyanide-bridged three-dimensional (3D) assembly, showing a ferrimagnetic ordering, frequency-dependent ac susceptibility, and hysteresis loops below 14.8 K. In addition, our feasible route to rationally design and prepare this new molecule-based ferrimagnet promises to provide new 3D cyanide-bridged complexes in the future research.

An unprecedented polyoxometalate-based 1D double chain compound with opposite charges enables conductivity improvement.

A POM-based one-dimensional (1D) chain compound, {BW12O40[Cu(2,2'-bipy)2]2[Cu(2,2'-bipy)(H2O)]}{BW12O40[Cu(2,2'-bipy)2][Cu(2,2'-bipy)(H2O)2]}·7H2O, has been synthesized and structurally characterized, which represents an unprecedented 1D double chain structure with opposite charges. In contrast to common POMs, this compound exhibits a relatively high electrical conductivity of 1.17 × 10-9 S cm-1 at 25 °C. In addition, its semiconducting properties have also been investigated by application of photoelectrochemical sensing of H2O2.

pH-Controlled assembly of [ZnW12O40]6--based hybrids from a 0D dimer to a 2D network: synthesis, crystal structure, and photocatalytic performance in transformation of toluene into benzaldehyde.

Polyoxometalate-based organic-inorganic hybrids have attracted considerable attention due to their fascinating structures and wide application prospects. In this work, using the same building blocks, ligands and metal ions (ZnW12O406-(ZnW12), 2,2'-bipyridine (2,2'-bipy), and Cu2+), we synthesized three new POM-based hybrids by controlling the pH values of the reaction systems. These three compounds {(Zn0.6(H2)0.4W12O40)[Cu(2,2'-bipy)(H2O)][Cu(2,2'-bipy)(H2O)2][Cu(2,2'-bipy)(H2O)3]}2·6H2O (1), (Me4N)2{ZnW12O40[Cu(2,2'-bipy)(H2O)][Cu(2,2'-bipy)(H2O)3]}·5H2O (2), and {(Zn0.5(H2)0.5W12O40)[Cu(2,2'-bipy)][Cu(2,2'-bipy)(H2O)][Cu(2,2'-bipy)(H2O)2]}·5H2O (3) have been structurally characterized by single-crystal X-ray diffraction. Compound 1 appears as a dimeric cluster structure, while compounds 2 and 3 appear as a 1D chain structure and a 2D network, respectively. The semiconducting properties of compounds 1-3 are different, which was demonstrated by band gap (Eg) and photocurrent response measurements. Compound 3 can efficiently catalyze the photooxidation of toluene to benzaldehyde with high selectivity using molecular oxygen as the oxidant component. Moreover, compound 3 was recycled and reused three times without significant degradation in conversion and selectivity. In addition, the mechanism of the photocatalytic reaction was also investigated.

Accelerated partial breast irradiation: Use of four-dimensional CT for target localization and assessment of intrafractional motion.

The aim of this study was to use four-dimensional CT (4DCT) in the planning of 3D conformational external beam radiation therapy (3DCRT) for patients with early stage breast cancer. A total of nine Chinese women who received breast conservation treatment were included in this study. Target localization and movement (range of motion) during normal respiration were assessed using ultrasound and 4DCT. Plans based on 3DCT and 4DCT scans were developed in accordance to RTOG0319 guidelines and dose delivery comparisons were made between these plans. The mean ranges of motion of the excision cavity volume as determined using 4DCT were 1.03 +/- 0.51, 2.08 +/- 0.92, and 1.27 +/- 0.58 mm in the right-left, anterior-posterior, and superior-interior directions, respectively. There were no significant differences between the mean and maximum PTV-E doses or the volume receiving 95% of the prescribed dose (V95). 4D plan prescribed dose levels were significantly lower (p < 0.05) than 3D plan levels for all of the following: ipsilateral breast V100, ipsilateral lung V30, and contralateral lung V5. Maximum contralateral breast and thyroid doses were also significantly lower with the 4D plan (p < 0.05). This study highlights the usefulness of 4DCT for the planning of 3DCRT in breast cancer patients. Our findings suggest that the use of 4DCT can lead to improvements in target definition and decreases in normal tissues irradiation.

The clinical value of adjuvant radiotherapy in patients with early stage breast cancer with 1 to 3 positive lymph nodes after mastectomy.

BACKGROUND AND OBJECTIVE: The role of postmastectomy radiotherapy (PMRT) in breast cancer patients with T1-T2 tumors and 1-3 positive axillary nodes is still uncertain. This study investigated the value of PMRT for these patients. METHODS: In the retrospective data of 488 eligible patients, survival analysis was performed using the Kaplan-Meier method. Univariate and multivariate analyses were performed using a log-rank test and the Cox proportional hazards model, respectively. RESULTS: The median observation time was 54 months. The 5- and 10-year locoregional recurrence-free survival (LRFS) rates were 90.8% and 86.9%, respectively. The 5- and 10-year disease-free survival (DFS) rates were 82.0% and 74.3%, respectively. The 5- and 10-year overall survival (OS) rates were 90.7% and 82.7%, respectively. For the 412 patients without PMRT, T2 classification, 2-3 positive nodes, and hormone (estrogen and progesterone) receptor-negative were risk factors for locoregional recurrence in the multivariate analysis. On the basis of these 3 risk factors, the group with 2-3 factors had a 10-year LRFS rate of 63.1% compared with 96.1% for the group with 0-1 factors (P < 0.001). For the group with 2-3 risk factors, LRFS and DFS were significantly improved by PMRT, with the 5- and 10-year LRFS rates without PMRT of 82.4% and 63.1%, respectively, and, with PMRT, of 98.1% at both 5 years and 10 years (P = 0.002). The 5- and 10-year DFS rates without PMRT were 72.0% and 57.6%, respectively, and, with PMRT, the 5- and 10-year DFS rates were 89.4% and 81.7%, respectively (P = 0.007). There was no significant difference in the 10-year OS rates between patients with and without PMRT. However, there is the potential benefit of 15.3% (87.1% vs. 71.8%, P = 0.072). Conversely, the group with 0-1 factors of PMRT had no effect on prognosis. CONCLUSIONS: In patients receiving mastectomy with T1-T2 breast cancer with 1-3 positive nodes, for the group with 2-3 risk factors, PMRT significantly improved LRFS and DFS and has potential benefit in OS.

Efficacy of X-ray stereotactic radiotherapy on brain metastases and prognostic analysis.

BACKGROUND AND OBJECTIVE: X-ray stereotactic radiotherapy (SRT) is one of the effective treatments for brain metastases (BM). This study was to evaluate the efficacy of SRT on BM, and investigate prognostic factors. METHODS: Between July 1999 and December 2004, a total of 122 intracranial lesions in 78 patients with BM were treated using SRT in our Center. Forty-nine patients had a solitary lesion and 29 had multiple (2-6) lesions. The median SRT dose was 15 Gy (11-24 Gy) in single fraction for 38 lesions, and 24 Gy (11-40 Gy) in 2-6 fractions for 84 lesions. SRT was combined with whole brain radiotherapy (WBRT) of 30-40 Gy for 39 patients. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan-Meier method. Univariate and multivariate analyses were performed by the log-rank test and Cox model, respectively. RESULTS: The median survival time was 12.9 months (1.7-77.4 months). The 1-year intracranial PFS rate was 87.4%. The 1-and 2-year OS rates were 53.9% and 25.8%, respectively. Univariate analysis showed that the 1-year OS rates were higher in the patients with pretreatment KPS of >/= 70, extracranial lesions controlled, or SRT combined with WBRT than in those with KPS of < 70 (60.7% vs. 29.4%, P = 0.002), extracranial lesions uncontrolled (69% vs. 44.9%, P = 0.005), or SRT alone (64.1% vs. 43.4%, P = 0.03). The benefit of treating with WBRT in combination was mainly achieved in the patients with extracranial lesions controlled or with more than one intracranial lesion. Multivariate analysis showed that KPS score and status of extracranial lesions were independent prognostic factors for OS. CONCLUSIONS: SRT is an effective and safe modality for BM. SRT combined with WBRT may prolong the survival time of the patients with extracranial lesions controlled or multiple intracranial lesions. Independent prognostic factors for OS are KPS score and status of extracranial lesions.

Real-world impact of postmastectomy radiotherapy in T1-2 breast cancer with one to three positive lymph nodes.

BACKGROUND: The utility of postmastectomy radiotherapy (PMRT) in breast cancer patients with T1-2 (tumor size ≤5 cm) and N1 (one to three lymph nodes involved) disease remains controversial. The aim of this population-based study was to investigate the effectiveness of PMRT in this patient subset in the current clinical practice. METHODS: We included T1-2N1 breast cancer patients treated with mastectomy from 2004 to 2012 using the data form the Surveillance, Epidemiology, and End Results program. The association of PMRT administration with breast cancer-specific survival was determined using multivariable Cox analysis. RESULTS: We identified 10,248 patients of this study, including 3,725 (36.3%) received PMRT and 6,523 (63.7%) patients did not receive PMRT. Use of PMRT showed increase from 2008 onward; the percentage of patients receiving PMRT was 30.6% in 2004 and was 47.1% in 2012 (P<0.001). Patients diagnosis after 2008, aged <50 years, high tumor grade, T2 stage, and ≥2 positive lymph nodes were independently related to PMRT receipt. Multivariate analysis indicated that PMRT was not related to better breast cancer-specific survival compared to those without PMRT both before (P=0.186) and after propensity score matching (P=0.137). CONCLUSIONS: In breast cancer with T1-2N1 disease, PMRT does not appear to improve survival in the era of modern systemic therapy.