title: Breast-conserving treatment in the elderly: long-term results of adjuvant hypofractionated and normofractionated radiotherapy.
abstract: OBJECTIVE
  To evaluate the long-term cause-specific survival (CSS), locoregional recurrence-free survival (LRFS), and metastases-free survival (MFS) in elderly breast cancer patients receiving adjuvant normofractionated (NF) or hypofractionated (HF) radiotherapy (RT).
  
  
  METHODS
  Between 1995 and 1999, 367 women aged >or=70 years with nonmetastatic Stage T1 or T2 tumors were treated by breast-conserving surgery and adjuvant RT at the Institut Curie. They underwent wide tumor excision with or without lymph node dissection followed by RT. They received either a NF-RT schedule, which delivered a total dose of 50 Gy (25 fractions, 5 fractions weekly) to the whole breast, followed by a boost to the tumor bed when indicated, or a HF-RT schedule, which delivered a total dose of 32.5 Gy (five fractions of 6.5 Gy, once weekly) with no subsequent boost. The HF-RT schedule was indicated for the more elderly patients.
  
  
  RESULTS
  A total of 317 patients were in the NF-RT group, with 50 in the HF-RT group. The median follow-up was 93 months (range, 9-140). The 5- and 7-year CSS, LRFS, and MFS rates were similar in both groups. The 5-year NF-RT and HF-RT rate was 96% and 95% for CSS, 95% and 94% for LRFS, and 94% and 95% for MFS, respectively. The 7-year NF-RT and HF-RT rate was 93% and 87% for CSS, 93% and 91% for LRFS, and 92% and 93% for MFS, respectively.
  
  
  CONCLUSIONS
  According to the findings from this retrospective study, the HF-RT schedule is an acceptable alternative to NF-RT for elderly patients. However, large-scale prospective randomized trials are needed to confirm these results.
authors.affiliation: Department of Radiation Oncology, Institut Curie, Paris, France. youlia.kirova@curie.net
authors.forename: Youlia M
authors.initials: YM
authors.lastname: Kirova
authors.forename: Francois
authors.initials: F
authors.lastname: Campana
authors.forename: Alexia
authors.initials: A
authors.lastname: Savignoni
authors.forename: Fatima
authors.initials: F
authors.lastname: Laki
authors.forename: Marius
authors.initials: M
authors.lastname: Muresan
authors.forename: Remi
authors.initials: R
authors.lastname: Dendale
authors.forename: Marc A
authors.initials: MA
authors.lastname: Bollet
authors.forename: Remy J
authors.initials: RJ
authors.lastname: Salmon
authors.forename: Alain
authors.initials: A
authors.lastname: Fourquet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome