{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T19:28:18Z","timestamp":1773257298779,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004328","name":"Genentech","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004328","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2020,12,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The goal of this study was to assess the impact of trastuzumab on locoregional failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The analysis included 2763 patients with HER2\u2010positive (HER2+) breast cancer who were randomly assigned to adjuvant doxorubicin (A), cyclophosphamide (C), paclitaxel (T) and trastuzumab (H) (arm A, AC\u2192T [n\u00a0=\u00a0922]; arm B, AC\u2192T\u2192H [n\u00a0=\u00a0988]; arm C, AC\u2192T+H\u2192H [n\u00a0=\u00a0853]). Radiotherapy was given after AC\u2192T concurrently with H. Radiotherapy was given after lumpectomy (L) or after mastectomy (M) with \u22654 positive lymph nodes but was optional for 1 to 3 positive lymph nodes. Locoregional failures at 10 years (LFR10) as first events were compared using competing risk analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up was 13.0 years. The first site of failure was local\u2010only in 96 cases, locoregional in 16 cases, regional in 32 cases, and not specified in 2 cases; LFR10 was 4.8% (95% CI 4.1%\u20105.7%). LFR10 was 5.5% (95% CI 4.3%\u20107.2%), 4.9% (95% CI 3.7%\u20106.4%), and 2.8% (95% CI 1.9%\u20104.1%) in arms A, B, and C (B vs A: hazard ratio [HR] 0.91, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.62; C vs A: HR 0.72, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.12). For estrogen receptor\u2013positive patients, LFR10 was 3.7% (95% CI 2.8%\u20104.8%) and for estrogen receptor\u2013negative patients, it was 6.1% (95% CI 5.0%\u20107.4%; HR 0.61, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.004). Local treatment included L+RT (n\u00a0=\u00a01044 [38%]), M+RT (n\u00a0=\u00a01025 [37%]), and M (n\u00a0=\u00a0694 [25%]). LFR10 was 6.% (95% CI 5.0%\u20107.8%), 3.0% (95% CI 2.1%\u20104.3%), and 5.5% (95% CI 4.0%\u20107.4%) for L+RT, M+RT, and M, respectively (M+RT vs L+RT: HR 0.43, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001; M vs L+RT: HR 0.88, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.57). For 1 to 3 positive lymph nodes, LFR10 was 6.5% (95% CI 4.8%\u20108.9%), 4.1% (95% CI 2.4%\u20107.0%), and 4.3% (95% CI 2.9%\u20106.5%) in L+RT, M+RT, and M, respectively (M vs L+RT: HR 0.68, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.14; M vs M+RT: HR 1.2, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.6).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low 10\u2010year LFRs were seen regardless of trastuzumab use. Differences in local therapy in patients with 1 to 3 positive lymph nodes did not appear to improve local control. Local therapy studies for HER2+ and other tumor characteristics are important as the role of local therapies continues to evolve.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33154","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T03:18:12Z","timestamp":1600658292000},"page":"5239-5246","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of adjuvant trastuzumab on locoregional failure rates in a randomized clinical trial: North Central Cancer Treatment Group N9831 (alliance) study"],"prefix":"10.1002","volume":"126","author":[{"given":"Carlos E.","family":"Vargas","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic Phoenix Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0564-6540","authenticated-orcid":false,"given":"Cameron S.","family":"Thorpe","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic Phoenix Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amylou C.","family":"Dueck","sequence":"additional","affiliation":[{"name":"Alliance Statistics and Data Center Mayo Clinic Scottsdale Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen S.","family":"Tenner","sequence":"additional","affiliation":[{"name":"Alliance Statistics and Data Center Mayo Clinic Scottsdale Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy E.","family":"Davidson","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology Fred Hutchinson Cancer Research Center Seattle Washington"},{"name":"Division of Medical Oncology University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvana","family":"Martino","sequence":"additional","affiliation":[{"name":"The Angeles Clinic and Research Institute Santa Monica California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas M.","family":"Pisansky","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. Shelley","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele Y.","family":"Halyard","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic Phoenix Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara A.","family":"Pockaj","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Phoenix Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edith A.","family":"Perez","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; Oncology Mayo Clinic Jacksonville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/35021093"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32417-5"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32616-2"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.55.5730"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0910383"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052122"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052306"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60488-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61629-2"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020128"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(96)00075-X"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.61.8413"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.13.5467"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.23.0946"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1075-122X.2006.00297.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2011.07.001"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1415340"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1415369"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.5565"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-019-0299-9"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.18205"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000441436"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2014.925580"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.72.7263"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.33154","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.33154","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.33154","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.33154","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T12:30:43Z","timestamp":1760272243000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.33154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,15]]},"references-count":25,"journal-issue":{"issue":"24","published-print":{"date-parts":[[2020,12,15]]}},"alternative-id":["10.1002\/cncr.33154"],"URL":"https:\/\/doi.org\/10.1002\/cncr.33154","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,15]]},"assertion":[{"value":"2020-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}