title: The impact of the loco-regional treatment in elderly breast cancer patients: hypo-fractionated exclusive radiotherapy, single institution long-term results.
abstract: OBJECTIVE
  To assess the efficacy of exclusive hypo-fractionated radiotherapy (HFRT) without previous breast-conserving surgery (BCS) in elderly women.
  
  
  METHODS
  From 1995 to 1999, we have treated with breast-conserving treatment 396 patients older than 70 years with early-stage breast cancer (T1,T2 tumours) at the Institut Curie, Paris, France. Seventy-nine consecutive elderly non-metastatic patients treated for early breast cancer have been treated with HFRT. Of them, 50 underwent BCS followed by HFRT of 32.5 Gy/5 fractions/5 weeks, and 29 patients (presented with different co-morbidities, inoperable or patients' refusal, and/or transportation problems) received the same HFRT schedule followed by a 13 Gy boost (two fractions of 6.5 Gy) as exclusive radiotherapy treatment. This population of 29 patients has been studied. In case of hormonal positive status, hormonal therapy was also proposed to the patients.
  
  
  RESULTS
  There was a median follow-up of 93 months (9-140 months). At 7-year follow-up, the cause-specific survival was 96.4% (confidence interval (CI) 95: 89.8.6-100%), the metastasis-free survival rate was 92.4% (CI 95: 82.8-100%) and the loco-regional control rate was 95.8% (CI 95: 88.2-100%).
  
  
  CONCLUSIONS
  This long-term follow-up retrospective study demonstrated acceptable local control and good outcome in elderly patients treated by exclusive HFRT for early breast cancer. However, large-scale prospective randomised trials are needed to confirm these results.
authors.affiliation: Radiation Oncology, Institut Curie, 26 rue d'Ulm, Paris, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.forename: Youlia M
authors.initials: YM
authors.lastname: Kirova
authors.forename: Fatima
authors.initials: F
authors.lastname: Laki
authors.forename: Alexia
authors.initials: A
authors.lastname: Savignoni
authors.forename: Thierry
authors.initials: T
authors.lastname: Dorval
authors.forename: Remi
authors.initials: R
authors.lastname: Dendale
authors.forename: Marc A
authors.initials: MA
authors.lastname: Bollet
authors.forename: Alain
authors.initials: A
authors.lastname: Fourquet
authors.forename: Francois
authors.initials: F
authors.lastname: Campana
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D018275:Carcinoma, Lobular / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D020360:Neoadjuvant Therapy; D016016:Proportional Hazards Models; D011882:Radiotherapy, High-Energy / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal