Will Your Breast Cancer Patient’s Mortality Go Up in Smoke?

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
David W. Mantik
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Recurrence Risk ◽  
The Other ◽  
Lung Damage ◽  
Major Contributor ◽  
Capillary Perfusion ◽  
Cell Hypoxia ◽  
Excited Luminescence

Dedicated smokers who receive breast radiation may pay an unexpected price[1]in both recurrence risk and in mortality. Smoking during radiation therapy (RT) noticeably increases (and accelerates) the recurrence risk, but it also increases long-term risks of lung and heart mortality. The recurrence risk probably derives from (temporary) smoking - caused hypoxia. On the other hand, concurrent RT and smoking produces synergistic and permanent heart and lung damage. Tumor cell hypoxia can be exogenous (via smoking) or endogenous (inadequate capillary perfusion) or possibly even environmental (at high altitudes). However it occurs, though, it is a major contributor to treatment failure. Techniques for addressing hypoxia - both currently in the clinic, and on the technological horizon - are briefly reviewed here. These include photoacoustics, FLASH radiotherapy, and Cherenkov - Excited Luminescence Imaging (CELI).

Fatigue in patients with adjuvant radiation therapy for breast cancer: long-term follow-up

2004 ◽  
Vol 130 (6) ◽  
pp. 327-333 ◽  
Author(s):  
Hans Geinitz ◽  
Frank B. Zimmermann ◽  
Reinhard Thamm ◽  
Monika Keller ◽  
Raymonde Busch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy ◽  
Long Term Follow Up

scholarly journals Lumpectomy Plus Tamoxifen With or Without Irradiation in Women Age 70 Years or Older With Early Breast Cancer: Long-Term Follow-Up of CALGB 9343

2013 ◽  
Vol 31 (19) ◽  
pp. 2382-2387 ◽  
Author(s):  
Kevin S. Hughes ◽  
Lauren A. Schnaper ◽  
Jennifer R. Bellon ◽  
Constance T. Cirrincione ◽  
Donald A. Berry ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Distant Metastasis ◽  
Early Stage ◽  
Breast Cancer Specific Survival ◽  
Cancer Specific Survival ◽  
Er Positive ◽  
Long Term Follow Up

Purpose To determine whether there is a benefit to adjuvant radiation therapy after breast-conserving surgery and tamoxifen in women age ≥ 70 years with early-stage breast cancer. Patients and Methods Between July 1994 and February 1999, 636 women (age ≥ 70 years) who had clinical stage I (T1N0M0 according to TNM classification) estrogen receptor (ER) –positive breast carcinoma treated by lumpectomy were randomly assigned to receive tamoxifen plus radiation therapy (TamRT; 317 women) or tamoxifen alone (Tam; 319 women). Primary end points were time to local or regional recurrence, frequency of mastectomy, breast cancer–specific survival, time to distant metastasis, and overall survival (OS). Results Median follow-up for treated patients is now 12.6 years. At 10 years, 98% of patients receiving TamRT (95% CI, 96% to 99%) compared with 90% of those receiving Tam (95% CI, 85% to 93%) were free from local and regional recurrences. There were no significant differences in time to mastectomy, time to distant metastasis, breast cancer–specific survival, or OS between the two groups. Ten-year OS was 67% (95% CI, 62% to 72%) and 66% (95% CI, 61% to 71%) in the TamRT and Tam groups, respectively. Conclusion With long-term follow-up, the previously observed small improvement in locoregional recurrence with the addition of radiation therapy remains. However, this does not translate into an advantage in OS, distant disease-free survival, or breast preservation. Depending on the value placed on local recurrence, Tam remains a reasonable option for women age ≥ 70 years with ER-positive early-stage breast cancer.

scholarly journals Long Term Arm and Shoulder Toxicities in Breast Cancer Patients Receiving Hypofractionated Radiation Therapy

2021 ◽  
Vol 6 (3) ◽  
pp. 311-315
Author(s):  
Prateek Daga ◽  
Harvinder Singh Kumar ◽  
Neeti Sharma ◽  
Shankar Lal Jakhar ◽  
Kamlesh Kumar Harsh
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Regional Nodal Irradiation ◽  
Therapy Assessment ◽  
Conventional Radiation ◽  
Hypofractionated Radiation ◽  
Fraction Dose

   Aim: The purpose of this study is to evaluate the late toxicities in hypo fractionated radiation schedule in breast cancer patients with regional nodal irradiation (RNI), limited to axilla and supraclavicular regions. Late effects on arm and shoulder were noted as follows: skin edema (lymphedema), restricted shoulder movements (brachial plexus injury) and localised pain.Material and Methods: In this study we randomly enrolled 100 breast cancer post mastectomy cases in the year 2018. All cases were previously asymptomatic after surgery. They were prospectively treated with hypo fractionated local and regional nodal irradiation by 2.67 gray / fraction dose, total 15 fractions (total dose-40 gray). Evaluation was done at 12 months after completion of radiation therapy. Assessment was done by RTOG, LENT- SOMA scales. Results: Significant lymphedema was observed in 17 (17%) cases. Restricted arm mobility was seen in 14 (14%) of patients. Pain (moderate/severe) in arm and shoulder was most commonly seen, in 25 (25%) cases. Conclusions: As hypo fractionated regimes in breast cancer treatment have become new standard; its late term effects are significant and comparable to other conventional radiation therapy regimes. These studies need further and longer duration of evaluation.    

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