[Influence of the delay between conservative surgery and radiation therapy on local relapse in node-positive breast tumor].
It has been shown that a delay in radiotherapy (RT) initiation resulted in a higher local relapse (LR) rate. The present analysis investigated retrospectively if the RT-adjuvant therapy sequence modified local-disease-free survival (L-DFS) after breast-conserving surgery (BCS) in node-positive (N +) breast cancer patients. Among seven French Adjuvant Study Group trials, 1,831 patients were assessable: 475 received RT directly after BCS, 567 after the 3rd chemotherapy (CT) cycle, and 789 after the 6th CT cycle. In the 1,356 patients receiving CT, it consisted of FEC regimens (fluorouracil, epirubicin, cyclophosphamide) in 83.5% of patients. After a 102-month median follow-up, 214 patients (11.7%) developed LR. The 9-year L-DFS rates were 92.0%, 81.5%, and 87.4%, respectively (p < 0.0001). In the multivariate analysis, the timing of RT was not associated with a higher rate of LR, whereas tumor size and hormonotherapy were prognostic factors. In our population, there was no increase in the risk of LR when RT was delayed to deliver adjuvant CT. Prognostic factors were tumor size, and hormonotherapy. The number of CT courses could modify this risk.
Benchalal
Mohamed
M
Département de radiothérapie, Centre Eugène Marquis, rue de la Bataille Flandres-Dunkerque, 35042 Rennes. m.benchalal@rennes.fnclcc.fr
Boisselier
Pierre
P
de Lafontan
Brigitte
B
Berton-Rigaud
Dominique
D
Belkacemi
Yazid
Y
Romestaing
Pascale
P
Peignaux
Karine
K
Courdi
Adel
A
Monnier
Alain
A
Montcuquet
Philippe
P
Goudier
Marie-Josèphe
MJ
Marchal
Christian
C
Chollet
Philippe
P
Abadie-Lacourtoisie
Sophie
S
Datchary
Jean
J
Veyret
Corinne
C
Kerbrat
Pierre
P
D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D018714:Radiotherapy, Adjuvant / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors