Therapeutic factors influencing the cosmetic outcome and late complications in the conservative management of early breast cancer
| Autor: | S.M. Deore, Vinay Sharma, Ketayun A. Dinshaw, Rajiv Sarin, Shyam K. Shrivastava |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Multivariate analysis Esthetics medicine.medical_treatment Brachytherapy Breast Neoplasms Mastectomy Segmental Adjuvant therapy Medicine Humans Radiology Nuclear Medicine and imaging Radiation Injuries Aged Neoplasm Staging Radiation business.industry Lumpectomy Cosmesis Cancer Radiotherapy Dosage Middle Aged medicine.disease Iridium Radioisotopes Combined Modality Therapy Surgery Radiation therapy Radiography Treatment Outcome Oncology Lymph Node Excision Regression Analysis Female business Mastectomy |
| Zdroj: | International journal of radiation oncology, biology, physics. 27(2) |
| ISSN: | 0360-3016 |
| Popis: | Purpose: To investigate the impact of clinical and physical parameters on the cosmetic result and complications, in cancer breast treated with conservative surgery and definitive irradiation. Methods and Materials: Between October 1980 and December 1990, 289 patients were treated with lumpectomy and/or axillary dissection, radical irradiation with or without adjuvant therapy. The radiation therapy technique consisted of external beam therapy followed by an Ir-192 implant or electron beam boost. Univariate and multivariate analysis were used to evaluate the correlation between multiple factors affecting the cosmetic outcome and the complications. Results: Of 289 patients, cosmesis was evaluable in 285 and recorded as excellent to good in 226 (79%), fair in 35 (12%), and poor in 24 (9%). On multivariate analysis of these results, a high dose per fraction (p = .0018), and use of electrons as boost to the tumor bed (p = .001) were found to be significant. When patients boosted with electrons were excluded, a high boost dose (p = .0433) was also found significant. Fifteen (5%) patients developed severe late radiation sequelae and 14 (5%) moderate or severe arm edema. On multivariate analysis only dose per fraction of 2.5 Gy (p < .0001) and higher boost doses (p = .017) were significant. Conclusion: In 289 patients of early breast cancer treated with conservative surgery and radical irradiation, multivariate analysis suggests that higher dose per fraction with teletherapy and higher brachytherapy boost dose adversely affect cosmesis and contribute to the late complications. |
| Databáze: | OpenAIRE |
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