Adjuvant Radiotherapy is Associated with an Increase of Survival of Old (Aged Over 80 Years) and Very Old (Aged Over 90 Years) Women with Breast Cancer Receiving Breast-Conserving Surgery

2021 ◽  
Author(s):  
Jiaqiang Zhang ◽  
Shao-Yin Sum ◽  
Chia-Lun Chang ◽  
Jeng-Guan Hsu ◽  
Ming-Feng Chiang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Older Women ◽  
Locoregional Recurrence ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Oncologic Outcomes ◽  
Breast Radiotherapy ◽  
Very Old ◽  
Breast Invasive Ductal Carcinoma ◽  
Whole Breast Radiotherapy

Abstract BACKGROUND: To date,no data on the effect of adjuvant whole-breast radiotherapy (WBRT) on oncologic outcomes, such as all-cause death, locoregional recurrence (LRR), and distant metastasis (DM), are available forold (aged ≥80 years) and very old (≥90 years) women with breast invasive ductal carcinoma (IDC) receiving breast-conserving conservative surgery (BCS).PATIENTS AND METHODS: We enrolled old (≥80 yearsold) and very old (≥90 yearsold) women with breast IDC who had received BCS followed by adjuvant WBRT or no adjuvant WBRT. We groupedthem based on adjuvant WBRT status and compared their overall survival (OS), LRR, and DM outcomes. To reduce the effects of potential confounders when comparing all-cause mortality between the groups, propensity score matching was performed.RESULTS:Overall, 752 older women with IDC received BCS followed by adjuvant WBRT, and 752 with IDC received BCS with no adjuvant WBRT.In multivariable Cox regression analysis, the adjusted hazard ratio (aHR) and 95% confidence interval (95% CI) of all-cause death for adjuvant WBRT compared with no adjuvant WBRT in older women with IDC receiving BCS was 0.56 (0.44-0.70). The aHRs (95% CIs) of LRR and DM foradjuvant WBRT were 0.29 (0.19-0.45) and 0.45 (0.32-0.62), respectively, compared with no adjuvant WBRT.CONCLUSION: Adjuvant WBRT was associated with decreases in all-cause death, LRR, and DM in old (aged ≥80 years) and very old (aged ≥90 years) women with IDC compared with no adjuvant WBRT.Condensed Abstract: This study is the first to examine the effect of adjuvant whole-breast radiotherapy (WBRT) on oncologic outcomes such as all-cause death, locoregional recurrence (LRR), and distant metastasis (DM) in old (aged ≥80 years) and very old (aged ≥90 years) women with breast invasive ductal carcinoma (IDC) receiving breast-conserving surgery. After propensity score matching, adjuvant WBRT was associated with decreases in all-cause death, LRR, and DM in old and very old women with IDC compared with no use of adjuvant WBRT.

scholarly journals Adjuvant Whole Breast Radiotherapy Improve Survival in Women with Heart Failure with Reduced Ejection Fraction Receiving Breast-Conserving Surgery

2021 ◽  
Vol 11 (12) ◽  
pp. 1358
Author(s):  
Jiaqiang Zhang ◽  
Shao-Yin Sum ◽  
Jeng-Guan Hsu ◽  
Ming-Feng Chiang ◽  
Tian-Shyug Lee ◽  
...  
Keyword(s):  
Heart Failure ◽  
Propensity Score ◽  
Ejection Fraction ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Oncologic Outcomes ◽  
Study Cohort ◽  
Breast Radiotherapy ◽  
Reduced Ejection Fraction ◽  
Whole Breast Radiotherapy

Background: to date, no data on the effect of adjuvant whole breast radiotherapy (WBRT) on oncologic outcomes, such as all-cause death, locoregional recurrence (LRR), and distant metastasis (DM), are available in women with left-side breast invasive ductal carcinoma (IDC) and heart failure with reduced ejection fraction (HFrEF). Patients and Methods: we included 294 women with left-breast IDC at clinical stages IA–IIIC and HFrEF receiving breast-conserving surgery (BCS) followed by adjuvant WBRT or non-adjuvant WBRT. We categorized them into two groups based on their adjuvant WBRT status and compared their overall survival (OS), LRR, and DM outcomes. We calculated the propensity score and applied inverse probability of treatment weighting (IPTW) to create a pseudo-study cohort. Furthermore, we performed a multivariate analysis of the propensity score–weighted population to obtain hazard ratios (HRs). Results: in the IPTW-adjusted model, adjuvant WBRT (adjusted HR [aHR]: 0.60; 95% confidence interval [CI]: 0.44–0.94) was a significant independent prognostic factor for all-cause death (p = 0.0424), and the aHR (95% CI) of LRR and DM for adjuvant WBRT was 0.33 (0.24–0.71; p = 0.0017) and 0.37 (0.22–0.63; p = 0.0004), respectively, compared with the non-adjuvant WBRT group. Conclusion: Adjuvant WBRT was associated with a decrease in all-cause death, LRR, and DM in women with left IDC and HFrEF compared with non-adjuvant WBRT.

scholarly journals Adjuvant Whole Breast Radiotherapy Improve Survival in Women with Heart Failure with Reduced Ejection Fraction Receiving Breast-Conserving Surgery

2021 ◽  
Author(s):  
Jiaqiang Zhang ◽  
Shao-Yin Sum ◽  
Jeng-Guan Hsu ◽  
Ming-Feng Chiang ◽  
Tian-Shyug Lee ◽  
...  
Keyword(s):  
Heart Failure ◽  
Propensity Score ◽  
Ejection Fraction ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
Oncologic Outcomes ◽  
Study Cohort ◽  
Breast Radiotherapy ◽  
Reduced Ejection Fraction ◽  
Whole Breast Radiotherapy

Abstract BACKGROUND: To date, no data on the effect of adjuvant whole breast radiotherapy (WBRT) on oncologic outcomes, such as all-cause death, locoregional recurrence (LRR), and distant metastasis (DM), are available in women with left-side breast intraductal carcinoma (IDC) and heart failure with reduced ejection fraction (HFrEF). PATIENTS AND METHODS: We enrolled 294 women with left-breast IDC at clinical stages IA–IIIC and HFrEF receiving breast-conserving surgery (BCS) followed by adjuvant WBRT or non-adjuvant WBRT. We categorized them into two groups based on their adjuvant WBRT status and compared their overall survival (OS), LRR, and DM outcomes. We calculated the propensity score and applied inverse probability of treatment weighting (IPTW) to create a pseudo-study cohort. Furthermore, we performed a multivariate analysis of the propensity score–weighted population to obtain hazard ratios (HRs).RESULTS: In the IPTW-adjusted model, adjuvant WBRT (adjusted HR [aHR]: 0.58; 95% confidence interval [CI]: 0.33–1.00) was a significant independent prognostic factor for all-cause death (P = 0.0494), and the aHR (95% CI) of LRR and DM for adjuvant WBRT was 0.25 (0.10–0.62; P = 0.0028) and 0.29 (0.14–0.60; P = 0.0007), respectively, compared with the nonadjuvant WBRT group. CONCLUSION: Adjuvant WBRT was associated with a decrease in all-cause death, LRR, and DM in women with left IDC and HFrEF compared with nonadjuvant WBRT.

Adjuvant Breast Radiotherapy Improve Survival in Women With Heart Failure

2021 ◽  
Author(s):  
Jiaqiang Zhang ◽  
Shao-Yin Sum ◽  
Jeng-Guan Hsu ◽  
Ming-Feng Chiang ◽  
Tian-Shyug Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Propensity Score ◽  
Oncologic Outcomes ◽  
Study Cohort ◽  
Cancer Death ◽  
Breast Radiotherapy ◽  
Reduced Ejection Fraction ◽  
Breast Cancer Death ◽  
Whole Breast Radiotherapy

Abstract BACKGROUND To date, no data on the effect of adjuvant whole breast radiotherapy (WBRT) on oncologic outcomes, such as all-cause death, locoregional recurrence (LRR), and distant metastasis (DM), are available in women with left-side breast intraductal carcinoma (IDC) and heart failure with reduced ejection fraction (HFrEF). PATIENTS AND METHODS : We enrolled 294 women with left-breast IDC at clinical stages IA–IIIC and HFrEF receiving breast-conserving surgery (BCS) followed by adjuvant WBRT or non-adjuvant WBRT. We categorized them into two groups based on their adjuvant WBRT status and compared their overall survival (OS), LRR, and DM outcomes. We calculated the propensity score and applied inverse probability of treatment weighting (IPTW) to create a pseudo-study cohort. Furthermore, we performed a multivariate analysis of the propensity score–weighted population to obtain hazard ratios (HRs). RESULTS In the IPTW-adjusted model, adjuvant WBRT (adjusted HR [aHR]: 0.60; 95% confidence interval [CI]: 0.44–0.94) was a significant independent prognostic factor for all-cause death (P = 0.0424), and the aHR (95% CI) of LRR and DM for adjuvant WBRT was 0.33 (0.24–0.71; P = 0.0017) and 0.37 (0.22–0.63; P = 0.0004), respectively, compared with the no adjuvant WBRT group. The aHR (95% CI) of breast cancer death for adjuvant WBRT was 0.54 (0.44–0.85; P = 0.0201) compared with no adjuvant WBRT group. CONCLUSION Adjuvant WBRT was associated with a decrease in all-cause death, breast cancer death, LRR, and DM in women with left IDC and HFrEF compared with no adjuvant WBRT.

A national multicenter study on 1072 DCIS patients treated with breast-conserving surgery and whole breast radiotherapy (COBCG-01 study)

2019 ◽  
Vol 131 ◽  
pp. 208-214 ◽  
Author(s):  
Icro Meattini ◽  
Nadia Pasinetti ◽  
Bruno Meduri ◽  
Fiorenza De Rose ◽  
Maria Carmen De Santis ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Breast Conserving Surgery ◽  
Breast Radiotherapy ◽  
Whole Breast Radiotherapy

scholarly journals Osteoradionecrosis of the Ribs following Breast Radiotherapy

2015 ◽  
Vol 8 (2) ◽  
pp. 332-338 ◽  
Author(s):  
Luke Nicholls ◽  
Peter Gorayski ◽  
Jennifer Harvey
Keyword(s):  
Chest Wall ◽  
Early Stage ◽  
Rare Complication ◽  
Breast Conserving Surgery ◽  
Radiation Sensitivity ◽  
Gene Profiling ◽  
Variable Response ◽  
Breast Radiotherapy ◽  
Whole Breast Radiotherapy ◽  
Standard Fractionation

Introduction: Osteoradionecrosis (ORN) of the chest wall is a rare complication after whole-breast radiotherapy (RT). Herein, we report a case of ORN involving the underlying ribs following adjuvant whole-breast RT using standard fractionation and conduct a review of the literature. Case Report: A previously well 43-year-old female with right-sided, early-stage, node-negative breast cancer was treated with breast-conserving surgery. She subsequently underwent adjuvant whole-breast RT receiving 50 Gy in 25 fractions over 5 weeks using standard tangential photon fields with 6 MV photons followed by an electron boost of 10 Gy in 5 fractions according to International Commission on Radiation Units (ICRU) requirements. Eleven months after RT, the patient developed right lateral chest wall pain, with magnetic resonance imaging (MRI) demonstrating two fractures involving the underlying right fifth and sixth ribs associated with fatty marrow changes in the second to sixth ribs, thus raising the possibility of ORN. Treatments including hyperbaric oxygen, pentoxifylline and vitamin E were used with symptomatic improvements. There was demonstrable resolution on follow-up MRI at 2.5 years. Conclusion: The incidence of ORN utilising modern RT techniques and standard fractionation is rare. Numerous treatments are available, with variable response rates. Emerging evidence of predictive gene profiling to estimate the risk of radiation sensitivity may assist in individualising preventative strategies to mitigate the risk of ORN.

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