Abstract OT2-04-02: A phase 3 study of post-lumpectomy radiotherapy to whole breast + regional lymph nodes vs whole breast alone for patients with pN1 breast cancer treated with taxane-based chemotherapy (KROG 1701): Trial in progress

Background

In patients with early stage breast cancer, regional nodal irradiation (RNI) is added to whole breast irradiation (WBI) in order to control microscopic regional disease and to prevent systemic spread of cancer. According to recent randomized trials (MA.20 and EORTC 22922-10925), prophylactic RNI was associated with improvement in disease-free survival (DFS) in the patients with high-risk node negative or pN1 breast cancer. However, systemic agents now known to improve loco-regional control, such as taxane or endocrine therapy, were prescribed to a small percentage of patients in the studies. The benefit of RNI found in the previous studies might be attributed to incorporation of less effective systemic treatments. The impact of prophylactic RNI in pN1 breast cancer should be evaluated in the patients receiving modern systemic treatment. The current study was conducted to compare the effect of post-lumpectomy WBI vs WBI plus RNI on DFS in pN1 breast cancer patients who received adjuvant taxane-based chemotherapy.

Methods

This study is a multicenter, phase 3, randomized controlled non-inferiority trial (NCT03269981). Eligibility criteria are ≥ 20 years female; pathologically proven invasive carcinoma of the breast; one to three positive axillary lymph nodes (pN1) in pathologic specimen; receiving breast-conserving surgery followed by taxane-based chemotherapy; having adjuvant endocrine therapy or anti-HER2 treatment according to molecular subtype of tumor. Patients are randomly assigned in a 1:1 ratio to receive WBI or WBI plus RNI. Patient randomization was stratified by molecular subtype of tumor (i.e. luminal A/luminal B/luminal HER2/HER2-enriched/triple-negative) and methods of axillary management (i.e. sentinel lymph node biopsy/axillary lymph node dissection). The primary outcome is DFS. The secondary outcomes include DFS according to molecular subtype, treatment-related toxicity, and patient's quality of life per EORTC QLQ-C30 and QLQ-BR23. Patients will be followed for survival and disease recurrence for seven years. A total of 1,926 patients are planned to be enrolled, with recruitment initiated in April 2017. As of June 2018, a total of 236 patients were enrolled.

Acknowledgement

This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (grant number: HA17C0043010018).

Citation Format: Kim H, Park W, Choi DH, Ahn SJ, Kim SS, Kim ES, Lee JH, Lee KC, Kim JH, Lee H-S, Kim JH, Kim MY, Park HJ, Kim K, Song SH, Kwon J, Lee IJ, Kim TH, Kim TG, Chang AR, Cho O, Jeong BK, Ha B, Lee J, Ki Y. A phase 3 study of post-lumpectomy radiotherapy to whole breast + regional lymph nodes vs whole breast alone for patients with pN1 breast cancer treated with taxane-based chemotherapy (KROG 1701): Trial in progress [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-04-02.

Concomitant developmental dental anomalies in Chinese children with dens evaginatus

AIM

To determine the prevalence of concomitant developmental dental anomalies in a group of Chinese children with dens evaginatus.

METHODS

The dental records and orthopantomograms of 10-15 year old children and adolescents who had been diagnosed with dens evaginatus in a school dental clinic were reviewed retrospectively.

RESULTS

Four hundred and forty-eight of 7102 (6.3%) children were found to have dens evaginatus. Concomitant developmental dental anomalies were found in 77 children (17.2%). The most commonly seen dental anomalies in the study population were hypodontia, hyperdontia, microdontic maxillary lateral incisor, and dental impaction. The prevalence of these anomalies did not differ significantly to that found in the general Chinese population. When analysed separately, however, the prevalence of supernumerary premolars was found to be higher in children with dens evaginatus than in the general population, and the difference was statistically significant (P < 0.01).

CONCLUSION

Supernumerary premolars appeared to be more prevalent in Chinese children with dens evaginatus than in the general population. There may be an association of supernumerary premolars with dens evaginatus in this study population.

Ca/P mol ratio of cries-affected dentin structures

BACKGROUND

A new approach called "minimum intervention" has been introduced for restoration of carious lesions to preserve tooth structure. This approach suggests that perhaps caries need not always be removed completely from deeper portions of the cavity. It is, therefore, important to characterize caries-affected dentin structures, because of the potential changes in bonding quality when using different dentinal substrates.

MATERIALS AND METHOD

Ninety teeth (30 teeth each group) were studied. The first group (CF) consisted of 30 caries-free teeth. The second group (CC) consisted of 30 teeth, for which caries-free dentin teeth was chemically demineralized. The third group (ND) consisted of 30 extracted human molars with coronal carious lesions. After all tooth samples were water-polished with grit #600 SiC paper, they were tested by surface contact angle measurements and the electron-probe microanalyzer to measure Ca/P mol ratio.

RESULTS

Contact angles were CF = 60.07 degrees ; CC = 30.8 degrees; ND = 26.11 degrees , p<0.05. Ca/P mol ratios were as follows; CF = 1.549 (+/-0.0435); CC = 1.324 (+/-0.2305); ND = 1.568 (+/-0.0523), p<0.05. Weibull analyses for Ca/P mol ratio indicated shape parameter (m) of CF was 13.3; it was 12.8 for ND and 11.8 for CC. Above the delta point (=1.65 in Ca/P ratio), for both groups m = 3.4.

CONCLUSION

Caries-affected dentin surfaces (naturally-developed and chemically created) were statistically more chemically active than caries-free dentin surface. Ca/P mol ratio of chemically created caries was less than other two groups.