Preoperative radiotherapy in breast cancer patients: 32 years of follow-up

Autor: Sofia Rivera, S. Heymann, Malek Ferchiou, Céline Bourgier, Suzette Delaloge, Ariane Dunant, F.G. Riet, F. Fayard, Chafika Mazouni, Rodrigo Arriagada, M.A. Santos
Přispěvatelé: Institut Gustave Roussy (IGR), Cancer Center Karolinska [Karolinska Institutet] (CCK), Karolinska Institutet [Stockholm], Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut du Cancer de Montpellier (ICM)
Jazyk: angličtina
Rok vydání: 2017
Předmět:
0301 basic medicine
Cancer Research
Time Factors
Receptor
ErbB-2
medicine.medical_treatment
[SDV]Life Sciences [q-bio]
Triple Negative Breast Neoplasms
Preoperative radiation therapy
Cohort Studies
0302 clinical medicine
Breast cancer
Mastectomy
Neoadjuvant therapy
Hypofractionated radiation therapy
Carcinoma
Ductal
Breast
Middle Aged
Prognosis
Neoadjuvant Therapy
3. Good health
Survival Rate
Receptors
Estrogen
Oncology
Carcinoma
Medullary
030220 oncology & carcinogenesis
Female
Adult
medicine.medical_specialty
Urology
Breast Neoplasms
Modified Radical Mastectomy
Disease-Free Survival
03 medical and health sciences
medicine
Humans
Radical surgery
Survival rate
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
Pathological complete response
Radiotherapy
business.industry
Triple-negative tumours
Postoperative complication
medicine.disease
Surgery
Radiation therapy
Carcinoma
Lobular
030104 developmental biology
Multivariate Analysis
Neoplasm Recurrence
Local
business
Follow-Up Studies
Zdroj: European Journal of Cancer
European Journal of Cancer, Elsevier, 2017, 76, pp.45-51. ⟨10.1016/j.ejca.2017.01.022⟩
ISSN: 0959-8049
DOI: 10.1016/j.ejca.2017.01.022⟩
Popis: International audience; This study evaluates the long-term outcomes of a retrospective cohort of breast cancer (BC) patients who had received curatively intended premastectomy radiation therapy (RT). We analysed locoregional control, disease-free survival (DFS) and overall survival (OS), pathological complete remission (pCR), predictors thereof, and immediate safety. The series consisted of 187 patients with a median age of 49 years [43-60] and T2-T4 or N2 tumours. Between 1970 and 1984, they had received slightly hypofractionated RT to the whole breast, ipsilateral supraclavicular fossa and axilla ± the internal mammary chain (45-55 Gy/18 fractions of 2.5 Gy/34 days) systematically followed by a modified radical mastectomy with an axillary dissection. No other preoperative treatment was given. Among the 166 centrally reviewed tumour biopsy specimens, 22% had a triple-negative (TN) phenotype, 17% were HER2 3 + or amplified and 61% were ER+. The median follow-up was 32 years [23-35]. The 25-year locoregional control rate was 89% [93%-82%] and the 25-year DFS and OS rates were identical, 30% [24%-37%]. A pCR in the tumour and lymph nodes had been achieved in 18 among all patients (10%), but in 26% with TN disease. In the multivariate analysis, the TN status was the only predictive factor of pCR (OR = 5.49, 95% confidence interval [CI] 1.87-16.1, p = 0.002). Also, the pN status (HR = 1.69, [1.28-2.22], p = 0.0002) and TN subtype (HR = 1.80, [1.00-3.26], p = 0.05) exerted a significant prognostic impact on OS. The postoperative complication rate (grade >2) was 19% with 4.3% of localized skin necrosis. Preoperative RT followed by radical surgery is feasible and associated with good long-term locoregional control.
Databáze: OpenAIRE
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