Impact of adjuvant hormonotherapy on radiation-induced breast fibrosis according to the individual radiosensitivity: results of a multicenter prospective French trial

Published on Mar 2, 2018in Oncotarget
· DOI :10.18632/ONCOTARGET.24606
K. Peignaux9
Estimated H-index: 9
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Abstract
// Celine Bourgier 1 , Florence Castan 1 , Olivier Riou 1 , Tan-Dat Nguyen 2 , Karine Peignaux 3 , Claire Lemanski 1 , Jean-Leon Lagrange 4 , Youlia Kirova 5 , Eric Lartigau 6 , Yazid Belkacemi 4 , Sofia Rivera 7 , Georges Noel 8 , Sebastien Clippe 9 , Francoise Mornex 10 , Christophe Hennequin 11 , Sophie Gourgou 1 , Muriel Brengues 1 , Pascal Fenoglietto 1 , Esat Mahmut Ozsahin 12 and David Azria 1 1 Institute de Recherche en Cancerologie de Montpellier, Inserm U1194, Universite de Montpellier, Institut Regional du Cancer de Montpellier, Montpellier, France 2 Institute Jean Godinot, Reims, France 3 Centre GF Leclerc, Dijon, France 4 AP-HP Henri Mondor, Creteil, France 5 Institute Curie, Paris, France 6 Centre Oscar Lambret, Lille, France 7 Gustave Roussy, Villejuif, France 8 Centre Paul Strauss, Strasbourg, France 9 Centre Marie Curie, Valence, France 10 Centre Hospitalier Lyon Sud, Pierre Benite, France 11 AP-HP Saint-Louis, Paris, France 12 Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland Correspondence to: David Azria, email: david.azria@icm.unicancer.fr Keywords: radiotherapy; breast cancer; hormonotherapy; individual radiosensitivity; late effects Received: November 30, 2017      Accepted: February 25, 2018      Epub: March 02, 2018      Published: March 20, 2018 ABSTRACT Background: To evaluate risk of severe breast fibrosis occurrence in patients treated by breast-conserving surgery, adjuvant radiotherapy and hormonotherapy (HT) according to individual radiosensitivity (RILA assay). Results: HT – and RILA high were the two independent factors associated with improved breast-fibrosis free survival (BFFS). BFFS rate at 36 months was lower in patients with RILA low and HT + than in patients with RILA high and HT – (75.8% and 100%, respectively; p = 0.004, hazard ratio 5.84 [95% confidence interval (CI) 1.8–19.1]). Conversely, BFFS at 36 months was comparable in patients with RILA high and HT + and in patients with RILA low and HT – (89.8% and 93.5%, respectively; p = 0.39, hazard ratio 1.7 [95% CI 0.51–5.65]), showing that these two parameters influenced independently the occurrence of severe breast fibrosis. BFFS rate was not affected by the HT type (tamoxifen or aromatase inhibitor) and timing (concomitant or sequential with radiotherapy). Conclusions: HT and RILA score independently influenced BFFS rate at 36 months. Patients with RILA high and HT – presented an excellent BFFS at 36 months (100%). Materials and methods: Breast Fibrosis-Free Survival (BFFS) rate was assessed relative to RILA categories and to adjuvant HT use (HT + and HT – , respectively) in a prospective multicentre study (NCT00893035) which enrolled 502 breast cancer patients (456 evaluable patients). Breast fibrosis was recorded according to CTCAE v3.0 grading scale; RILA score was defined according to two categories (<12%: RILA low ; ≥12%: RILA high ).
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