title: [Prospective monocentric study of the toxicity and the efficacy of concurrent trastuzumab and radiotherapy].
abstract: OBJECTIVE
  Prospective monocentric study of the toxicities related to concurrent administration of trastuzumab to breast radiotherapy.
  
  
  METHODS
  One hundred and seventy-three patients were treated between June 2003 and March 2009 by concurrent trastuzumab with normofractionated radiotherapy. Trastuzumab was delivered every 3 weeks (8mg/kg in the first infusion then 6mg/kg) during a median time of 12 months (2-62). Left ventricular ejection fraction was assessed by echocardiography or cardiac scintigraphy at baseline, before and after radiotherapy, every 3 months for 1 year and annually. A left ventricular ejection fraction strictly lower than 55% was considered as altered. All toxicities were evaluated using Common Terminology Criteria for Adverse Effects version 3.0.
  
  
  RESULTS
  Median follow-up was 52 months (17-88). Median age was 52 years (25-83). One hundred and thirty-four patients (77.5%) received radiotherapy to the internal mammary chain. Acute grade 1, 2 and 3 epithelitis was described in 132 (76.3%), 32 (18.5%) and six patients (3.4%), respectively. At 23 months, grade 1 and 2 fibrosis was observed in 31 and eight patients, respectively (18.8 and 4.6%). Left ventricular ejection fraction remained normal for 159 patients (91.9%) before radiotherapy. Among them, 18 (11.3%) experienced a left ventricular ejection fraction alteration, eight (5.0%) at the completion of radiotherapy. Congestive heart failure occurred in one patient (0.6%).
  
  
  CONCLUSIONS
  Toxicities related to the association of trastuzumab to breast radiotherapy were mild. Further follow-up is warranted.
authors.affiliation: Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France. julian.jacob28@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Jacob
authors.forename: L
authors.initials: L
authors.lastname: Belin
authors.forename: A
authors.initials: A
authors.lastname: Gobillion
authors.forename: C
authors.initials: C
authors.lastname: Daveau-Bergerault
authors.forename: R
authors.initials: R
authors.lastname: Dendale
authors.forename: P
authors.initials: P
authors.lastname: Beuzeboc
authors.forename: F
authors.initials: F
authors.lastname: Campana
authors.forename: M-A
authors.initials: MA
authors.lastname: Bollet
authors.forename: A
authors.initials: A
authors.lastname: Fourquet
authors.forename: Y M
authors.initials: YM
authors.lastname: Kirova
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000401:mortality / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000628:therapy; D059248:Chemoradiotherapy / Q000009:adverse effects*; D004941:Esophagitis / Q000209:etiology; D005260:Female; D005355:Fibrosis / Q000209:etiology; D006801:Humans; D008209:Lymphedema / Q000209:etiology; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D011855:Radiodermatitis / Q000209:etiology; D012867:Skin / Q000473:pathology; D013318:Stroke Volume / Q000187:drug effects / Q000528:radiation effects; D013684:Telangiectasis / Q000209:etiology; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068878:Trastuzumab