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Dr. Joseph Delano Fule Robles, 5 days ago

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Timing of RT initiation does not improve long-term outcome in breast cancer

12 Aug 2017

Starting radiation therapy (RT) shortly after breast-conserving surgery (BCS) does not appear to yield improvements in long-term outcome, bringing into question the common position that RT should be initiated as soon as possible following surgery so as to increase treatment efficacy in breast cancer patients, according to a recent study.

The study included two cohorts of women with primary invasive stage I to IIIA breast cancer and treated with BCS+RT. Cohort 1 (n=2,759) excluded patients receiving chemotherapy before RT, and analysis was stratified according to the use of adjuvant systemic therapy (AST). Cohort 2 (n=1,120) comprised patients who received chemotherapy, and analysis was performed by comparing chemotherapy before (BCS-chemotherapy-RT) and after RT (BCS-RT-chemotherapy).

The primary endpoint was disease-free survival (DFS), as estimated using multivariable Cox regression. Locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS) were also evaluated as secondary endpoints.

Cohort 1 showed better DFS and DMFS for a time interval of >55 vs <42 days. Patients who received AST had even higher DFS for >55 days (hazards ratio [HR], 0.60; 95 percent CI, 0.38 to 0.94) and for 42 to 55 days (HR, 0.64; 0.45 to 0.91) than for <42 days. A similar pattern of results was observed for DMFS, whereas timing had no effect on LRRFS and OS.

Among patients without AST, timing showed no association with DFS, DMFS and LLRFS. However, 10-year OS was notably lower for a time interval of 42 to 55 and >55 vs <42 days.

In cohort 2, timing did not influence survival among patients who received BCS-chemotherapy-RT. For those who had BCS-RT-chemotherapy, DMFS was higher for a time interval of >55 than <42 days.

The present data suggest initiating RT as soon as possible after BCS is not necessary as timing does not improve survival rates, researchers said. It is important that patients are informed about this to prevent them from worrying about tumour growth and worse outcomes in case of a longer time interval between BCS and RT.

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Most Read Articles
Dr. Joseph Delano Fule Robles, 5 days ago

A recent study conducted by The University of Hong Kong (HKU) revealed that long-term use of proton pump inhibitors (PPIs) is associated with a significantly increased risk of gastric cancer even in patients who have had Helicobacter pylori eradicated. 

5 days ago
The 5-year survival rates for human papillomavirus (HPV)-associated cancers vary greatly according to age and race, with Caucasians and younger patients tending to have better survival, according to a recent US study.
6 days ago
High levels of marijuana exposure appear to not be longitudinally associated with prevalent albuminuria and substantial changes in estimated glomerular filtration rate by cystatin C (eGFRcys), a recent US epidemiological study has shown.
4 days ago
Men with breast cancer have tumours that are typically of the human epidermal growth factor receptor 2-negative Luminal B subtype and positive for oestrogen receptor, progesterone receptor and androgen receptor, according to the results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program study.