Optimal Combination of Adjuvant Radiotherapy and Immunotherapy for Breast Cancer

Inclusion Criteria:

1. Age 18-65 years;

2. Triple negative invasive breast cancer, with immunohistochemistry confirming thatthe primary lesion was ER- or ER<10% and weakly expressed, PR-, HER 2-;

3. Patients who had surgery after neoadjuvant immunotherapy, and required ahypofractionated radiotherapy regimen of whole breast/chest wall ± regional lymphnodes ±tumor bed: whole breast/chest wall ± regional lymph nodes DT 40.05Gy/15F;Sequential dose increase of DT 2.9 Gy*3F for tumor bed in breast conservingpatients; For patients with a stage of T4 or N3c, it is up to the radiationoncologist to decide whether to proceed with sequential bolsing of locoregionallesions;

4. Patients received adjuvant immunotherapy after neoadjuvant immunotherapy, and thedrugs used for postoperative immune maintenance were the immunodrugs used in theneoadjuvant treatment stage;

5. Patients who have not received neoadjuvant immunotherapy and require 1 year ofadjuvant immunotherapy and hypofractionated intensity-modulated radiotherapy forwhole breast/chest wall ± regional lymph nodes ± tumor beds in the postoperativeadjuvant stage.

Exclusion Criteria:

1. Failure to complete the course of radiotherapy as planned

2. Concomitant contralateral breast cancer or second primary malignancy (except basalcell carcinoma of the skin and carcinoma in situ of the cervix);

3. Previous history of thoracic radiotherapy;

4. Serious heart, lung, liver, kidney, hematopoietic and nervous system diseases,mental diseases;

5. Concomitant autoimmune diseases such as scleroderma or active lupus erythematosus;pregnant and lactating patients;

6. Patients with prior immunotherapy-related grade 3-4 toxicities during theneoadjuvant immunotherapy phase