scholarly journals Sole adjuvant intraoperative breast radiotherapy in Taiwan: a single-center experience

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Hsin-Yi Yang ◽  
Chi-Wen Tu ◽  
Chien-Chin Chen ◽  
Cheng-Yen Lee ◽  
Yu-Chen Hsu
Keyword(s):  
Breast Cancer ◽  
Adjuvant Radiotherapy ◽  
Locoregional Recurrence ◽  
External Beam Radiotherapy ◽  
Significant Risk ◽  
Intraoperative Radiotherapy ◽  
Breast Cancer Patients ◽  
Clinicopathologic Characteristics ◽  
Oncological Outcomes ◽  
The Impact

Abstract Introduction Intraoperative radiotherapy (IORT) is more convenient than standard whole breast external beam radiotherapy (EBRT) as a sole adjuvant radiotherapy for breast cancer. The impact of age on breast cancer course and treatment strategy is still under investigation, and the peak age for breast cancer in Taiwan is much younger than that in Western countries. We aimed to review the oncological outcomes of sole IORT compared with standard EBRT in a country with younger breast cancer patients. Patients and methods We reviewed patients with invasive breast cancer who received breast-conserving surgery (BCS) from September 2014 to December 2016. The clinicopathologic characteristics and oncological outcomes of eligible patients who received EBRT or IORT as sole adjuvant radiotherapy after BCS were collected and reviewed. Results A total of 170 patients were enrolled with a mean follow-up time of 3.53 ± 0.82 years. The risk of locoregional recurrence was 2.44% for EBRT versus 10.64% for IORT (p = 0.024). IORT was a significant risk factor of locoregional recurrence (p = 0.005). The hazard ratios (HRs) for locoregional recurrence in the IORT group compared with the EBRT group were significantly higher in non-suitable risk group patients (HR = 7.02, p = 0.009) and in patients under 50 years old (HR = 10.42, p = 0.011). Conclusions Locoregional recurrence was significantly higher in patients who received IORT than in those who underwent EBRT. IORT should not be used alone in patients under 50 years old who do not belong to a suitable group.

Sole Adjuvant Intraoperative Breast Radiotherapy in Taiwan: A Single-Center Experience

2020 ◽  
Author(s):  
Hsin-Yi Yang ◽  
Chi-Wen Tu ◽  
Yu-Chen Hsu
Keyword(s):  
Breast Cancer ◽  
Adjuvant Radiotherapy ◽  
Locoregional Recurrence ◽  
External Beam Radiotherapy ◽  
Significant Risk ◽  
Intraoperative Radiotherapy ◽  
Breast Cancer Patients ◽  
Clinicopathologic Characteristics ◽  
Oncological Outcomes ◽  
The Impact

Abstract Introduction: Intraoperative radiotherapy (IORT) is more convenient than standard whole-breast external beam radiotherapy (EBRT) as a sole adjuvant radiotherapy for breast cancer. The impact of age on breast cancer course and treatment strategy is still under investigation, and the peak age for breast cancer in Taiwan is much younger than that in Western countries. We aimed to review the oncological outcomes of sole IORT compared with standard EBRT in a country with younger breast cancer patients.Patients and methods: We reviewed patients with invasive breast cancer who received breast-conserving surgery (BCS) from September 2014 to December 2016. The clinicopathologic characteristics and oncological outcomes of eligible patients who received EBRT or IORT as sole adjuvant radiotherapy after BCS were collected and reviewed.Results: A total of 170 patients were enrolled with a mean follow-up time of 3.53 ± 0.82 years. The risk of locoregional recurrence was 2.44% for EBRT versus 10.64% for IORT (p = 0.024). IORT was a significant risk factor of locoregional recurrence (p = 0.005). The hazard ratios (HRs) for locoregional recurrence in the IORT group compared with the EBRT group were significantly higher in non-suitable risk group patients (HR = 7.02, p = 0.009) and in patients under 50 years old (HR = 10.42, p = 0.011).Conclusions: Locoregional recurrence was significantly higher in patients who received IORT than in those who underwent EBRT. IORT should not be used alone in patients under 50 years old who do not belong to a suitable group.

Abstract 14206: Assessing a Clinical Risk Score and the Impact of Race in Breast Cancer Patients at Risk of Cardiotoxicity

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Zachary Brumberger ◽  
Mary Branch ◽  
Joseph Rigdon ◽  
Suji Vasu
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Risk Score ◽  
Significant Risk ◽  
Statistical Characteristics ◽  
Risk Scores ◽  
Clinical Risk Score ◽  
Breast Cancer Patients ◽  
Clinical Risk ◽  
The Impact

Introduction: Cardiotoxicity is a well-known risk in breast cancer patients treated with anthracyclines and trastuzumab. Ezaz et al. developed a clinical risk score (CRS) to risk stratify these patients. Despite evidence that African American (AA) race is a significant risk factor for cardiotoxicity, no study has assessed the impact of AA race on this CRS. Here we assess the discrimination ability of the Ezaz et al. CRS with the addition of AA race. Methods: This is a retrospective cohort utilizing a registry of 118 patients with stage I-IV breast cancer treated with anthracyclines and/or trastuzumab. Patients without baseline echocardiography data or with baseline LVEF < 50% were excluded. The CRS from Ezaz et al. consisting of age, adjuvant chemotherapy, coronary artery disease, atrial fibrillation or flutter, diabetes mellitus, hypertension, and renal failure was calculated with the addition of AA race. Cardiotoxicity was defined by an LVEF decline of ≥ 10% to LVEF < 53% from baseline. Results: In our 118 patient cohort, the mean age was 59 years, 23 (20%) AA patients, 65 (55%) patients considered low risk (scores of 0-3) and 53 (45%) considered moderate to high risk (scores ≥4). After a follow up of 3 months to 5 years, 14 (12%) patients developed cardiotoxicity. Table 1 lists the CRS changes in statistical characteristics and predictability with the addition of AA race. In comparing the models, the AUC c-statistic increased from 0.609 to 0.642 (95% CI 0.47-0.75, 95% CI 0.49-0.79 respectively; P value = 0.56) with the addition of AA race ( Figure 1 ). Conclusions: In this study, the Ezaz et al. CRS demonstrated improved discrimination and sensitivity with the addition of AA race. This study suggests AA race improves the predictive ability of the Ezaz et al. CRS. Given the limited size of our study, we promote that this should be hypothesis-driving and encourage further investigation on the path to develop an important risk stratification tool.

scholarly journals A review of the impact of exercise on treatment-related fatigue among patients receiving adjuvant radiotherapy for breast cancer

2019 ◽  
Vol 18 (03) ◽  
pp. 295-300 ◽  
Author(s):  
Fiona McNally ◽  
Paul H. Shepherd ◽  
Terri Flood
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Pharmacological Intervention ◽  
Breast Cancer Patients ◽  
Exercise Interventions ◽  
Guidance Needs ◽  
The Impact

AbstractPurposeTo evaluate the use of exercise in managing fatigue in breast cancer patients undergoing adjuvant radiotherapy. To explore the effectiveness of different exercise practices and explore how optimum management of fatigue might be achieved.MethodA CINAHL (Cumulative Index to Nursing and Allied Health Literature) database search of literature was undertaken and publications screened for retrieval with 24 qualifying for inclusion in the review.ResultsThere is evidence to support various forms of exercise including aerobic, resistance, alternative and combination exercise in the management of fatigue in early stage breast cancer patients undergoing adjuvant radiotherapy. The benefits of exercise for patients with later stage and metastatic disease is less clear and there is a lack of published research related to this category of patient.ConclusionExercise is considered a safe, non-pharmacological intervention for early stage breast cancer patients receiving adjuvant radiotherapy. Further investigation is required into optimum exercise interventions and the effectiveness and viability of supervised and unsupervised models. Patient centred tailored advice and guidance needs to be developed and effectively promoted by therapeutic radiographers in order for patients to fully realise the benefit.

scholarly journals The Effect of Intraoperative Radiotherapy on Breast Cancer: Focus on the Levels of Angiogenic Factors

2021 ◽  
Author(s):  
Nahid Nafisi ◽  
Maryam Mohammadlou ◽  
Mohammad Esmaeil Akbari ◽  
Seyed Rabie Mahdavi ◽  
Maryam Sheikh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Linear Regression Analysis ◽  
Intraoperative Radiotherapy ◽  
Angiogenic Factors ◽  
Breast Cancer Patients ◽  
Risk Of Death ◽  
Post Surgery ◽  
Before And After ◽  
The Impact

Abstract Objective: Angiogenesis is one of the hallmarks of cancers that is involved in tumor progression. Angiogenic factors induce the formation of new blood vessels and tumor extension, and finally reduce the survival of patients. Intraoperative radiotherapy (IORT), in which radiation is delivered to the tumor bed can kill cells and change tumor microenvironment. Here, we compared the impact of IORT on the levels of angiogenic factors in the blood and surgical wound fluids (SWF) of the breast cancer patients. Patients and Methods: Blood and drained wound fluid (WF) samples were collected from the breast cancer patients before and after surgery, followed by quantification of the amounts of TGF-β, EGF, FGF, VEGF and DLL4 in the patients using ELISA.Results: Our results were indicative of significant differences between the pre-surgery and post-surgery serum levels of EGF, DLL4 and VEGF. In addition, linear regression analysis showed the significant impact of IORT, vascular invasion and lymph node (LN) involvement on the difference between TGF-β levels in the blood before and after surgery-IORT. According to the outcomes of multivariate analysis, IORT changed the levels of EGF and FGF in the blood and WF. Furthermore, logistic regression analyses showed that TGF-β and EGF can be used as predictor markers of the late-stage and LN involvement of the disease. Interestingly, IORT was able to reduce the risk of death and the recurrence rate of disease. Conclusions: In summary, IORT is a safe and effective treatment that can affect angiogenesis and improve the survival of breast cancer patients.

Locoregional recurrence risks in elderly breast cancer patients treated with mastectomy without adjuvant radiotherapy

2005 ◽  
Vol 41 (9) ◽  
pp. 1267-1277 ◽  
Author(s):  
Pauline T. Truong ◽  
Junella Lee ◽  
Hosam A. Kader ◽  
Caroline H. Speers ◽  
Ivo A. Olivotto
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Adjuvant Radiotherapy ◽  
Locoregional Recurrence ◽  
Breast Cancer Patients

Impact of endocrine therapy in early-stage breast cancer on time to locoregional recurrence.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 64-64
Author(s):  
Ines B. Menjak ◽  
Ellen Maki ◽  
Hal K. Berman ◽  
Caroline Chung ◽  
David R. McCready ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Locoregional Recurrence ◽  
Early Stage ◽  
Menopausal Status ◽  
Retrospective Chart Review ◽  
Distant Metastases ◽  
Breast Cancer Patients ◽  
Receptor Status ◽  
The Impact

64 Background: Locoregional recurrence (LR) remains a major source of morbidity and mortality in breast cancer. Our primary aim was to evaluate the impact of endocrine therapy (ET) on time to LR. Methods: A retrospective chart review of breast cancer patients (pts) treated with lumpectomy and locoregional radiation from 1999-2005 at the Princess Margaret Cancer Centre was carried out. LR was defined as ipsilateral breast or lymph node recurrence. Kaplan-Meier estimates of survival and univariate analyses were performed for age, menopausal status, tumor and nodal stage, grade, receptor status, adjuvant chemotherapy (AC) and ET. Results: Of 440 pts evaluated, the mean age at primary resection was 56 years (yrs) (range 40-79), and 67% were postmenopausal. The majority had ductal carcinomas (87%) and grade 1-2 (68%) tumors. Tumor distribution was 315 (72%) T1, 120 (27%) T2, 4 (1%) T3; 138 (31%) were node positive. Receptor status was ER/PR+HER2- 206 (47%), ER+PR+HER2unknown 80 (18%), ER-PR-HER2unknown 41 (9%), and triple negative 37 (8%). AC was used in 190 (43%). ET (tamoxifen and/or aromatase inhibitors) was initiated in 294 (84%) eligible pts, and 267/294 (91%) completed a minimum duration of ≥2 yrs. Overall, LR occurred in 24 (5%) pts, and 8/24 (33%) pts with LR also had distant metastases. Average time from surgery to LR was 5.4 yrs (range 8 months-12 yrs). The average duration of ET in pts with LR was 4.3 yrs (range 0-8), and 5.8 yrs (range 0-12) without LR. Of ER/PR+ pts with LR, 3/15 (20%) did not receive ET. At the time of LR, 5 (33%) pts were receiving ET. After stopping ET, 2 (13%) recurred 0-2 yrs, 3 (20%) at 4-5 yrs, and 2 (13%) at 7-8 yrs. Treatment with at least 2 yrs of ET predicted for fewer recurrences: at 2 yrs LR-free rate was 100% vs 90% for <2 yrs ET; at 5 yrs 99.6% vs 84%; and at 8 yrs 98.2% vs 84% (p=0.0092). ER/PR+HER2- pts had lower LR risk (p=0.028), and ER-/PR-/HER+ had higher LR risk (p=0.029). The remaining variables were not associated with risk of LRs. Survival post-LR was 90% (95%CI 64-97%) at 2 yrs and 65% (95%CI 34-84%) at 5 yrs. Conclusions: Pts who completed at least 2 yrs of ET had significantly lower risk of LR. The average time to LR was 5.4 years, and pts with LR had decreased survival at 5 yrs post-recurrence.

Sign in / Sign up

Export Citation Format

Share Document