Shakeel Sumodhee1, Johan Levy2, Emmanuel Chamorey3, Daniel Lam Cham Kee1, Marie-Eve Chand1, Mathieu Gautier1, Isabelle Peyrottes4, Emmanuel Barranger5, Jean-Michel Hannoun-Levi6. 1. Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Cote d'Azur, Nice, France. 2. Department of Radiation Oncology, La Tronche Academic Hospital, Grenoble, France. 3. Biostatistic Unit, Antoine Lacassagne Cancer Center, University of Cote d'Azur, Nice, France. 4. Department of Pathology, Antoine Lacassagne Cancer Center, University of Cote d'Azur, Nice, France. 5. Department of Breast Surgery, Antoine Lacassagne Cancer Center, University of Cote d'Azur, Nice, France. 6. Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Cote d'Azur, Nice, France. Electronic address: jean-michel.hannoun-levi@nice.unicancer.fr.
Abstract
PURPOSE: Regarding adjuvant radiation therapy making decision for elderly women, Albert (2013) published a nomogram predicting the mastectomy-free survival (MFS) rate with or without adjuvant irradiation. Based on this approach, we proposed to investigate the use of accelerated partial breast irradiation (APBI) vs. whole breast irradiation (WBI) or endocrine therapy alone in elderly low-risk breast cancer patients. METHODS AND MATERIALS: For each elderly woman treated by conserving surgery and APBI (multicatheter interstitial high-dose-rate brachytherapy), 5- and 10-year MFS rates were calculated. For each treated patient, using the Albert nomogram, we calculated the estimated MFS rates at 5 and 10 years, with and without WBI. Then, we compared the estimated MFS rates after no irradiation and WBI vs. observed MFS rates after APBI. RESULTS: From 2005 to 2016, 79 patients were treated. Median followup was 96.8 months [68.6-104.9], median age was 77 years [66-89]. Expected 5- and 10-year mastectomy rates calculated with the Albert nomogram without WBI were 2.95% and 7.25%, respectively, leading to a 10-year MFS rate of 92.7%. Expected 5- and 10-year mastectomy rates after WBI were 1.41% and 3.66%, respectively, leading to a 10-year MFS rate of 96.3%. Regarding observed MFS rate, 1 pt (1.3%) experienced a salvage mastectomy. The 10-year MFS rate after APBI was 97.4% vs. 96.3% after WBI (p = 1) and 92.7% after no irradiation (p = 0.27). No toxicity Grade 3 or more was observed. CONCLUSIONS: APBI seems to be an attractive compromise between WBI and no irradiation for elderly women with early stage breast cancer as far as local control, quality of life and cost benefit is concerned.
PURPOSE: Regarding adjuvant radiation therapy making decision for elderly women, Albert (2013) published a nomogram predicting the mastectomy-free survival (MFS) rate with or without adjuvant irradiation. Based on this approach, we proposed to investigate the use of accelerated partial breast irradiation (APBI) vs. whole breast irradiation (WBI) or endocrine therapy alone in elderly low-risk breast cancerpatients. METHODS AND MATERIALS: For each elderly woman treated by conserving surgery and APBI (multicatheter interstitial high-dose-rate brachytherapy), 5- and 10-year MFS rates were calculated. For each treated patient, using the Albert nomogram, we calculated the estimated MFS rates at 5 and 10 years, with and without WBI. Then, we compared the estimated MFS rates after no irradiation and WBI vs. observed MFS rates after APBI. RESULTS: From 2005 to 2016, 79 patients were treated. Median followup was 96.8 months [68.6-104.9], median age was 77 years [66-89]. Expected 5- and 10-year mastectomy rates calculated with the Albert nomogram without WBI were 2.95% and 7.25%, respectively, leading to a 10-year MFS rate of 92.7%. Expected 5- and 10-year mastectomy rates after WBI were 1.41% and 3.66%, respectively, leading to a 10-year MFS rate of 96.3%. Regarding observed MFS rate, 1 pt (1.3%) experienced a salvage mastectomy. The 10-year MFS rate after APBI was 97.4% vs. 96.3% after WBI (p = 1) and 92.7% after no irradiation (p = 0.27). No toxicity Grade 3 or more was observed. CONCLUSIONS:APBI seems to be an attractive compromise between WBI and no irradiation for elderly women with early stage breast cancer as far as local control, quality of life and cost benefit is concerned.
Authors: Nam P Nguyen; Ulf Karlsson; Eromosele Oboite; Julio Alvarenga; Juan Godinez; Alice Zamagni; Micaela Motta; Satya Bose; Vincent Vinh-Hung Journal: Transl Cancer Res Date: 2020-01 Impact factor: 1.241
Authors: Igor Sirák; Miroslav Hodek; Pavel Jandík; Jakub Grepl; Petr Paluska; Jiří Petera Journal: Transl Cancer Res Date: 2020-01 Impact factor: 1.241