scholarly journals Prospective Study of Intensity-Modulated Radiation Therapy for Locally Advanced Breast Cancer

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3852
Author(s):  
Benoît Bataille ◽  
Bennadji Raoudha ◽  
Florence Le Tinier ◽  
Laurent Basson ◽  
Alexandre Escande ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Radiation Therapy ◽  
Lymph Node ◽  
Prospective Study ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Disease Free Survival

The objective of this study was to evaluate the acute and medium-term toxicities, the quality of life, and aesthetic results of patients with breast cancer (BC) treated with tomotherapy. This was a prospective study, including patients with BC treated by tomotherapy. Radiation therapy delivered 50 Gy in 25 fractions to the breast or chest wall and to lymph node areas, with a simultaneous integrated boost at a dose of 60 Gy at the tumor bed in cases of breast conservative surgery. We included 288 patients, 168 and 120 treated with breast-conserving surgery and mastectomy respectively. Two hundred sixty patients (90.3%) received lymph node irradiation. Median follow-up was 25 months (6–48). Acute dermatitis was observed in 278 patients (96.5%), mostly grade 1 (59.7%). The aesthetic aspect of the breast at one year was reported as “good” or “excellent” in 84.6% of patients. The patients’ quality of life improved over time, especially those treated with chemotherapy. The two-year overall survival and disease-free survival were 97.8% (95% confidence interval (CI): 94.1–99.2%), and 93.4% (95% CI: 89.2–96.0%) respectively. Tomotherapy for locally advanced BC has acceptable toxicity, supporting its use in this indication; however, longer follow-up is needed to assess long-term outcomes.

scholarly journals COMPARISON OF QUALITY OF LIFE OF PATIENTS WITH LOCAL DISTRIBUTED BREAST CANCER FORMS AFTER CHEMOTHERAPY IN REGIONAL AND SYSTEM REGIMES

2018 ◽  
Vol 3 ◽  
pp. 12-20
Author(s):  
Yuriy Dumanskiy ◽  
Oleksandr Bondar ◽  
Oleksandr Tkachenko ◽  
Evhenii Stoliachuk ◽  
Vasilii Ermakov
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Comprehensive Treatment ◽  
Important Indicator ◽  
Female Population ◽  
Individual Level ◽  
Significant Difference

For several decades, breast cancer (BC) undoubtedly ranks first in the structure of oncopathology and is the most common cause of the loss of working capacity of the female population in most countries. Considering the increasing quality of care for patients with breast cancer, there is the need for standardization and implementation of methods to assess not only quantitative but also qualitative component of a comprehensive opinion on the results of therapy. Therefore, an important indicator to be taken into account is the quality of life (QL) of a patient. Definition of QL of patients with inoperable forms of locally advanced breast cancer before and after neoadjuvant courses of systemic polychemotherapy (SPCT) and selective intra-arterial polychemotherapy in combination with systemic (SIAPCT). 154 patients with LA BC T4A-DN0-3M0, who received comprehensive treatment on the basis of the Donetsk regional antitumor center and the University clinic of the Odessa National Medical University during the period from 2000 to 2017, who received SPCT or SIAPCT as a neoadjuvant course, were included in the study. According to the quality of life during the treatment period, wavelike dynamics with a clear advantage of selective intra-arterial polychemotherapy over the system was observed. According to the quality of health between groups, the marginal statistically significant difference in favour of regional PCTs was formed. In a detailed study of each of the options found stable symptomatic scale dependent components of the integral index of quality of life on the severity and duration of intoxication syndrome. On the basis of the results obtained, the statistical advantage of the RMRM remains with the regional PCT. The QL study is a reliable, informative and economical method for assessing the health status of the patient, both at the group and at the individual level. In cancer studies, the evaluation of QL is an important criterion for assessing the effectiveness of treatment and has a prognostic value.

scholarly journals Quality of Life During Chemotherapy for Breast Cancer in a West African Population in Dakar, Senegal: A Prospective Study

2019 ◽  
pp. 1-9
Author(s):  
Domitille Dano ◽  
Clémence Hénon ◽  
Ousseynou Sarr ◽  
Kanta Ka ◽  
Mouhamadou Ba ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Prospective Study ◽  
Locally Advanced ◽  
Lymph Node Involvement ◽  
Nausea And Vomiting ◽  
University Hospital ◽  
Cancer Therapies ◽  
Middle Income

PURPOSE The prevalence of breast cancer is increasing in low- to middle-income countries such as Senegal. Our prospective study assessed the quality of life (QoL) of patients with breast cancer undergoing chemotherapy in Senegal. PATIENTS AND METHODS Our study included women with breast cancer undergoing chemotherapy as initial treatment at the Center Aristide Le Dantec University Hospital in Dakar. Clinical, sociodemographic, and QoL data were collected and analyzed at three different times: baseline, 3 months, and 6 months after the start of systemic therapy. Health-related QoL was assessed using a Functional Assessment of Cancer Therapies-Breast (FACT-B) questionnaire after translation into the Wolof language. Linear mixed-effects models were performed to assess the changes in QoL scores. RESULTS Between July 2017 and February 2018, 120 patients were included in the study. Their median age was 45 years. Most patients (n = 105; 92%) had locally advanced disease (T3 to T4 stage) and lymph node involvement (n = 103; 88%), and half had metastatic disease. The FACT-B total scores significantly improved over time (β = 1.58; 95% CI, 0.50 to 2.67; P < .01). Nausea and vomiting were significantly associated with a decrease in FACT-B total scores (β = −16.89, 95% CI, −29.58 to −4.24, P = .012; and β = −13.44, 95% CI, −25.15 to −1.72, P = .028, respectively). CONCLUSION Our study confirmed the feasibility of standardized QoL assessment in Senegalese patients with breast cancer. Our results indicated a potential improvement of QoL over the course of chemotherapy. Optimizing nausea and vomiting prevention may improve QoL.

scholarly journals Oncological safety of immediate rectus abdominis myocutaneous breast reconstruction in patients with locally advanced disease (stage IIb and III)

2013 ◽  
Vol 02 (04) ◽  
pp. 239-242
Author(s):  
Mushtaq Mir ◽  
Muddassir Shahdhar ◽  
Khurshid Ganaie ◽  
Quibtiya Syed
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Breast Reconstruction ◽  
Systemic Therapy ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Immediate Breast Reconstruction ◽  
Rectus Abdominis ◽  
Reconstructed Breast

Abstract Background: The management of locally advanced (Stage IIb and III) breast cancer is challenging. It often includes multimodal treatment with systemic therapy and/or radiation therapy and surgery. Immediate breast reconstruction has not traditionally been performed in these patients. We review the results of immediate rectus abdominis musculo-cutaneous (TRAM/VRAM) flap in 60 patients treated for Stage IIb and III breast cancer. Materials and Methods: Data were collected prospectively on 60 patients diagnosed with Stage IIb (32 patients) and Stage III (28 patients) breast cancer between May 2008 and May 2012. All patients had mastectomy and immediate rectus abdominis myocutaneous reconstruction (TRAM in 40 patients and VRAM in 20 patients). All patients received primary systemic therapy, and all patients received postoperative radiotherapy to the operative site. Results: Mean age was 40.13 (range 28-53) years, mean hospital stay was 8.86 days and mean follow-up for the group was 28 months. Neither of them developed local disease recurrence in the operative site till the last follow-up. Eight (13.3%) patients had some delay in chemo-radiation therapy due to flap-related complications. Flap-related complications were present in eight patients (partial flap failure in four and superficial skin necrosis in four). There was no adverse effect of chemo-radiation therapy on reconstructed breast. Conclusion: Immediate TRAM/VRAM breast reconstruction for locally advanced breast cancer is not associated with a significant delay in adjuvant therapy or an increased risk of local relapse. Radiation therapy can be delivered to the reconstructed breast when indicated without difficulty. Breast reconstruction facilitates surgical resection of locally advanced breast cancer with primary closure and should be considered if the patient desires immediate breast reconstruction.

MELATONIN AND METFORMIN IN NEOADJUVANT HORMONOTHERAPY IN LOCALLY ADVANCED BREAST CANCER

2018 ◽  
Vol 64 (5) ◽  
pp. 612-619
Author(s):  
Tatyana Semiglazova ◽  
Yevgeniya Tsyrlina ◽  
Artem Poltoratskiy ◽  
Yekaterina Busko ◽  
Vladislav Semiglazov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Advanced Breast Cancer ◽  
Hormone Therapy ◽  
Locally Advanced Breast Cancer ◽  
Objective Response ◽  
Locally Advanced ◽  
Study Groups ◽  
Ki 67

Materials and methods. The effect of melatonin (MLT) and metformin (MTF) on the efficacy of neoadjuvant hormone therapy with toremifene was investigated in 54 patients with estrogen receptor-positive, locally advanced breast cancer (ER + BC). The average age of women was 67 years. The patients had no diabetes mellitus. The first group of patients (n = 19) received toremifene 120 mg per day, the second group (n = 16) - toremifene in combination with MLT 3 mg orally every night, the third group (n = 19) - toremifene in combination with MTF 850 mg twice daily. Randomization was performed - 1: 1: 1. The duration of therapy in all study groups was 4 months. After the end of treatment, all patients were undergone surgery. Further adjuvant treatment depended on the results of the postoperative pathomorphological conclusion. The primary endpoint was a decrease in the Ki-67% level (a surrogate marker for the effectiveness of hormone therapy), the secondary endpoints were the objective response, a pathological response in the tumor and lymph nodes, and the quality of life. Results. In all patients (n = 54), the frequency of decrease Ki-67 level and the frequency of objective response were 57% and 50%, respectively. At the same time, the incidence of Ki-67% level decrease in the «toremifene» group was 42%, in the «toremifene+MLT» group - 56%, in the «toremifene+MTF» group - 74%. Multifactor analysis showed that the addition of MTF to toremifene increases the chances of reducing Ki-67 compared with control 4.2 times (RR 4.23 [95% CI 1,04417,139], p = 0.043). It is important that only in the patients of the «toremifene+MTF» group a significant correlation was found between the Ki-67 index decrease in the tumor and the BMI value above the norm (p = 0.015). A complete pathomorphological response in the tumor and lymph nodes was not achieved in any patient. The objective response in the study groups was 31.6%, 86.7% and 47.3%, respectively. The addition of MLT to hormone therapy with toremifene significantly increased the frequency of the objective response from 31.6% to 86.7% (x2 = 10.32, p = 0.001). The inclusion into neoadjuvant hormone therapy with toremifene of MLT or MTF did not reduce the quality of life of patients, while in 50% of patients in the «toremifene+MLT» group there was an improvement in sleep.

Quality of Life at 2 years Follow-up After Sentinel Lymph Node Biopsy, Immediate or Delayed Axillary Dissection for Breast Cancer

2010 ◽  
Vol 16 (5) ◽  
pp. 555-557 ◽  
Author(s):  
Maryam Al Nakib ◽  
Max Buttarelli ◽  
Laetitia Huiart ◽  
Marc Martino ◽  
Carole Tarpin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Axillary Dissection ◽  
Lymph Node Biopsy ◽  
Node Biopsy
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