Re-irradiation for locally recurrent refractory breast cancer
Identifieur interne : 001920 ( Main/Exploration ); précédent : 001919; suivant : 001921Re-irradiation for locally recurrent refractory breast cancer
Auteurs : Tomas Merino [Canada, Chili] ; William T. Tran [Canada] ; Gregory J. Czarnota [Canada]Source :
- Oncotarget [ 1949-2553 ] ; 2015.
Abstract
To report an analysis of treatment outcomes of a cohort of patients re-irradiated for locally recurrent refractory breast cancer (LRRBC)
Between 2008 and 2013, 47 women (mean age = 60 years) were re-irradiated for LRRBC. Outcomes were measured using Kaplan-Meier log rank to compare curves and Cox regression for multivariate analysis. Outcomes included overall survival (OS), time to re-treatment, survival without systemic progression, and survival without local recurrence.
Fifty-six instances of re-irradiation were completed and analyzed. The mean cumulative 2 Gy equivalent dose (EQD2) to the whole breast and tumour cavity (α/β = 3) was 99.8 Gy and 109.1 Gy, respectively. Most patients initially had significant symptoms before RT due to local recurrence. The median time to re-treatment and to systemic failure was 41 and 50 months, respectively. Median follow-up for OS was 17 months and OS was 0.73 (SE = 0.07) at 1 year and 0.67 (SE = 0.07) at 2 years. Local control was 0.62 (SE = 0.07) and 0.5 (0.08) at 1 and 2 years, respectively. Acute radiation dermatitis was G1-2, G3 and G4 in 45, 4 and 1 cases, respectively. One patient presented with necrosis. The most common long term toxicity was G3 fibrosis (
High dose re-irradiation is feasible for locally RRBC. This approach can have a significant benefit in this very high-risk group.
Url:
PubMed: 26459388
PubMed Central: 4741508
Affiliations:
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Tran</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea> Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Czarnota, Gregory J" sort="Czarnota, Gregory J" uniqKey="Czarnota G" first="Gregory J." last="Czarnota">Gregory J. Czarnota</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea> Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="A2"> Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea> Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26459388</idno><idno type="pmc">4741508</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741508</idno><idno type="RBID">PMC:4741508</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000806</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000806</idno><idno type="wicri:Area/Pmc/Curation">000806</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000806</idno><idno type="wicri:Area/Pmc/Checkpoint">000F25</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000F25</idno><idno type="wicri:Area/Ncbi/Merge">007A10</idno><idno type="wicri:Area/Ncbi/Curation">007A10</idno><idno type="wicri:Area/Ncbi/Checkpoint">007A10</idno><idno type="wicri:Area/Main/Merge">001922</idno><idno type="wicri:Area/Main/Curation">001920</idno><idno type="wicri:Area/Main/Exploration">001920</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Re-irradiation for locally recurrent refractory breast cancer</title><author><name sortKey="Merino, Tomas" sort="Merino, Tomas" uniqKey="Merino T" first="Tomas" last="Merino">Tomas Merino</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea> Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="A2"> Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea> Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="A3"> Departamento de Hemato-Oncologia, Pontificia Universidad Catolica de Chile, Santiago, Chile</nlm:aff><country xml:lang="fr">Chili</country><wicri:regionArea> Departamento de Hemato-Oncologia, Pontificia Universidad Catolica de Chile, Santiago</wicri:regionArea><wicri:noRegion>Santiago</wicri:noRegion></affiliation></author><author><name sortKey="Tran, William T" sort="Tran, William T" uniqKey="Tran W" first="William T." last="Tran">William T. Tran</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea> Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Czarnota, Gregory J" sort="Czarnota, Gregory J" uniqKey="Czarnota G" first="Gregory J." last="Czarnota">Gregory J. Czarnota</name><affiliation wicri:level="1"><nlm:aff id="A1"> Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea> Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="A2"> Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea> Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j">Oncotarget</title><idno type="eISSN">1949-2553</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>To report an analysis of treatment outcomes of a cohort of patients re-irradiated for locally recurrent refractory breast cancer (LRRBC)</p></sec><sec><title>Patients and Methods</title><p>Between 2008 and 2013, 47 women (mean age = 60 years) were re-irradiated for LRRBC. Outcomes were measured using Kaplan-Meier log rank to compare curves and Cox regression for multivariate analysis. Outcomes included overall survival (OS), time to re-treatment, survival without systemic progression, and survival without local recurrence.</p></sec><sec><title>Results</title><p>Fifty-six instances of re-irradiation were completed and analyzed. The mean cumulative 2 Gy equivalent dose (EQD2) to the whole breast and tumour cavity (α/β = 3) was 99.8 Gy and 109.1 Gy, respectively. Most patients initially had significant symptoms before RT due to local recurrence. The median time to re-treatment and to systemic failure was 41 and 50 months, respectively. Median follow-up for OS was 17 months and OS was 0.73 (SE = 0.07) at 1 year and 0.67 (SE = 0.07) at 2 years. Local control was 0.62 (SE = 0.07) and 0.5 (0.08) at 1 and 2 years, respectively. Acute radiation dermatitis was G1-2, G3 and G4 in 45, 4 and 1 cases, respectively. One patient presented with necrosis. The most common long term toxicity was G3 fibrosis (<italic>n</italic> = 4) and telangiectatic changes (<italic>n</italic> = 3). Multivariable analysis indicated that skin involvement (Hazard Ratio = 6.6 (1.4-31), <italic>p</italic> = 0.016) and time to local recurrence <2yr (HR 3.1 (1.04-9.7) <italic>p</italic> = 0.042) predicted local recurrence.</p></sec><sec><title>Conclusion</title><p>High dose re-irradiation is feasible for locally RRBC. 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uniqKey="Rutgers E">EJ Rutgers</name></author><author><name sortKey="Geijsen, Ed" uniqKey="Geijsen E">ED Geijsen</name></author><author><name sortKey="Zum Vorde Sive Vording, Pj" uniqKey="Zum Vorde Sive Vording P">PJ Zum vorde sive vording</name></author><author><name sortKey="Koning, Cc" uniqKey="Koning C">CC Koning</name></author><author><name sortKey="Van Tienhoven, G" uniqKey="Van Tienhoven G">G Van tienhoven</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Canada</li><li>Chili</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Merino, Tomas" sort="Merino, Tomas" uniqKey="Merino T" first="Tomas" last="Merino">Tomas Merino</name></noRegion><name sortKey="Czarnota, Gregory J" sort="Czarnota, Gregory J" uniqKey="Czarnota G" first="Gregory J." last="Czarnota">Gregory J. Czarnota</name><name sortKey="Czarnota, Gregory J" sort="Czarnota, Gregory J" uniqKey="Czarnota G" first="Gregory J." last="Czarnota">Gregory J. Czarnota</name><name sortKey="Merino, Tomas" sort="Merino, Tomas" uniqKey="Merino T" first="Tomas" last="Merino">Tomas Merino</name><name sortKey="Tran, William T" sort="Tran, William T" uniqKey="Tran W" first="William T." last="Tran">William T. Tran</name></country><country name="Chili"><noRegion><name sortKey="Merino, Tomas" sort="Merino, Tomas" uniqKey="Merino T" first="Tomas" last="Merino">Tomas Merino</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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