1 / 11

Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation

Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. Harry Bartelink et al. Introduction. Similar rates of survival after BCS vs mastectomy NSABP 06 50 Gy reduced LR from 35% to 10% Little known about the effect of doses > 50 Gy.

phuoc
Download Presentation

Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation Harry Bartelink et al

  2. Introduction • Similar rates of survival after BCS vs mastectomy • NSABP 06 50 Gy reduced LR from 35% to 10% • Little known about the effect of doses > 50 Gy

  3. EORTC trial • Standard RdTx 50 Gy to whole breast vs • Standard RdTx + 16 Gy boost to tumour bed. • 1989-1996 5569 patients with stage I or II breast Ca • Had to be completely excised • 90% prob of detecting a 5% improvement

  4. Eligibility • Stage I or II breast Ca, <70 years of age • Complete excision • Oral informed consent • 31 Centres from 9 countries

  5. Surgical 1cm margins Incomplete margins Involved nodes lead to chemo or tamoxifen Radiotherapy two tangential megavoltage photon beams 50 Gy over 5 weeks in 2 Gy fractions Boost 16 Gy to centre of excision Margin of 1.5cm Treatment

  6. Both groups similar 24 re-excisions 99% patients had axillary dissection Mean number of nodes 12 13% had haematoma 17% seroma +/- infection in axilla Mean time to RdTx 39 days without chemo Mean time to RdTx 52 days with chemo 272 patients had axillary RdTx Results

  7. LR 182/2657 in the 50Gy only group LR 109 /2661 in the 50Gy + 16Gy boost group 5yr LR rates of 7.3% & 4.3% LR was first event in 5.9% of standard group & 3.3% in the boost group Overall 47% of LR occurred in the primary tumour bed, 9% in the scar & 27% were diffuse throughout the breast Local Control

  8. Local control • Largest benefit of boost to be in the <40 years of age group • Benefit of additional dose in LR was independent of systemic chemo

  9. Side effects of the booster dose • Grades of fibrosis similar between the 2 groups • Excellent cosmetic results obtained in 86% of patients in standard group compared with 71% in the boost group

  10. Discussion • This study investigated the effects of an additional 16 Gy dose to standard 50Gy irradiation to the breast • Resulted in 41% relative reduction in LR rate • Absolute benefit depends on an individual patients risk of LR • Only significant factor was age

More Related