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.
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.
Authors: Aurora Rodríguez Pérez; Maria Concepción López Carrizosa; Pilar Maria Samper Ots; José Fermín Pérez-Regadera Gómez; José Zapatero Ortuño; Juan de Dios Sáez Garrido; Manuel Joaquín Martín de Miguel Journal: Clin Transl Oncol Date: 2012-09-14 Impact factor: 3.405
Authors: M Arenas; S Sabater; V Hernández; I Henríquez; A Ameijide; Ll Anglada; E Mur; M Artigues; A Lafuerza; J Borras Journal: Clin Transl Oncol Date: 2006-05 Impact factor: 3.405
Authors: A T P M Brands-Appeldoorn; A J G Maaskant-Braat; W A R Zwaans; J P Dieleman; K E Schenk; C L Broekhuysen; H Weerdenburg; R Daniels; V C G Tjan-Heijnen; R M H Roumen Journal: Curr Oncol Date: 2018-12-01 Impact factor: 3.677
Authors: Bharath Rangarajan; Tanuja Shet; Tabassum Wadasadawala; Nita S Nair; R Madhu Sairam; Sachin S Hingmire; Jyoti Bajpai Journal: South Asian J Cancer Date: 2016 Jul-Sep