[How to combine hormonotherapy and radiation treatment in adjuvant breast cancer?].
Combined radiation and hormone therapies have become common clinical practice in recent years for locally-advanced prostate cancers. The use of such concomitant therapy in the treatment of breast disease has been infrequently reported in the literature, but seems justified given the common hormonal dependence of breast cancer and the potential synergistic effect of these two treatment modalities. As adjuvant therapy, two strategies are used in daily clinical practice: upfront aromatase inhibitors or sequentially after a variable delay of tamoxifen. These molecules may, thus, interact with radiotherapy. Retrospectives studies recently published did not show any differences in terms of locoregional recurrences between concurrent or sequential radiohormonotherapy. Lung and skin fibroses due to concurrent treatment are still under debate. Nevertheless, late side effects appeared to be increased by such a treatment, particularly in hypersensitive patients identified at risk by the lymphocyte predictive test. Concurrent radiohormonotherapy should, thus, be delivered cautiously at least for these patients. This article details the potent advantages and risks of concurrent use of adjuvant hormonotherapy and radiotherapy in localized breast cancers.
Azria
D
D
Département d'Oncologie-Radiothérapie, Inserm U860, CRLC Val d'Aurelle-Paul-Lamarque, rue Croix-Verte, Montpellier Cedex 5, France. azria@valdorel.fnclcc.fr
Ozsahin
M
M
Gligorov
J
J
Zaman
K
K
Llacer Moscardo
C
C
Lemanski
C
C
Jacot
W
W
Belkacémi
Y
Y
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D018714:Radiotherapy, Adjuvant; D013629:Tamoxifen / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D013629:Tamoxifen