[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.
Département de radiothérapie, Centre Eugène Marquis, rue de la Bataille Flandres-Dunkerque, 35042 Rennes. m.benchalal@rennes.fnclcc.fr
Mohamed
M
Benchalal
Pierre
P
Boisselier
Brigitte
B
de Lafontan
Dominique
D
Berton-Rigaud
Yazid
Y
Belkacemi
Pascale
P
Romestaing
Karine
K
Peignaux
Adel
A
Courdi
Alain
A
Monnier
Philippe
P
Montcuquet
Marie-Josèphe
MJ
Goudier
Christian
C
Marchal
Philippe
P
Chollet
Sophie
S
Abadie-Lacourtoisie
Jean
J
Datchary
Corinne
C
Veyret
Pierre
P
Kerbrat
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