Predictors of the risk of fibrosis at 10 years after breast conserving therapy for early breast cancer - A study based on the EORTC trial 22881-10882 'boost versus no boost'

被引:167
作者
Collette, Sandra [1 ]
Collette, Laurence [1 ]
Budiharto, Tom [1 ]
Horiot, Jean-Claude [2 ]
Poortmans, Philip M. [3 ]
Struikmans, Henk [4 ]
Van den Bogaer, Walter [5 ]
Fourquet, Alain [6 ]
Jagerg, Jos J. [7 ]
Hoogenraad, Willem [8 ]
Mueller, Rolf-Peter [9 ]
Kurtz, John [10 ]
Morgan, David A. L. [11 ]
Dubois, Jean-Bernard [12 ]
Salamon, Emile [13 ]
Mirimanoff, Rene [14 ]
Bolla, Michel [15 ]
Van der Hulst, Marleen [3 ]
Warlam-Rodenhuis, Carla C. [16 ]
Bartelink, Harry [17 ]
机构
[1] EORTC Headquarters, Dept Stat, Brussels, Belgium
[2] Ctr Georges Francois Leclerc, Dept Radiat Oncol, Dijon, France
[3] Dr Bernard Verbeeten Inst, Dept Radiat Oncol, Tilburg, Netherlands
[4] Leiden Univ, Med Ctr, Dept Radiat Oncol, Leiden, Netherlands
[5] Univ Hosp Gasthuisberg, Dept Radiat Oncol, B-3000 Louvain, Belgium
[6] Inst Curie, Dept Radiat Oncol, Paris, France
[7] Radiotherapeut Inst Limburg, Dept Radiat Oncol, Heerlen, Netherlands
[8] Radboud Univ Nijmegen, Med Ctr, Dept Radiat Oncol, NL-6525 ED Nijmegen, Netherlands
[9] Univ Kliniken Koln, Dept Radiat Oncol, Cologne, Germany
[10] Hosp Cantonal Univ Geneva, Dept Radiat Oncol, Geneva, Switzerland
[11] City Hosp Nottingham, Dept Radiat Oncol, Nottingham, England
[12] CRLC Val Aurelle, Dept Radiat Oncol, Montpellier, France
[13] Clin St Elizabeth, Dept Radiat Oncol, Namur, Belgium
[14] CHU Vaudois, Dept Radiat Oncol, CH-1011 Lausanne, Switzerland
[15] CHU Grenoble, Dept Radiat Oncol, F-38043 Grenoble, France
[16] Univ Med Ctr, Dept Radiat Oncol, Utrecht, Netherlands
[17] Netherlands Canc Inst, Dept Radiat Oncol, Amsterdam, Netherlands
关键词
Fibrosis; Breast conserving treatment; Boost irradiation; Nomograms; Early breast cancer;
D O I
10.1016/j.ejca.2008.07.032
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The EORTC 22881-10882 trial in 5178 conservatively treated early breast cancer patients showed that a 16 Gy boost dose significantly improved local control, but increased the risk of breast fibrosis. To investigate predictors for the long-term risk of fibrosis, Cox regression models of the time to moderate or severe fibrosis were developed on a random set of 1797 patients with and 1827 patients without a boost, and validated in the remaining set. The median follow-up was 10.7 years. The risk of fibrosis significantly increased (P < 0.01) with increasing maximum whole breast irradiation (WBI) dose and with concomitant chernotherapy, but was independent of age. In the boost arm, the risk further increased (P < 0.01) if patients had post-operative breast oedema or haematoma, but it decreased (P < 0.01) if WBI was given with >6 MV photons. The c-index was around 0.62. Nomograms with these factors are proposed to forecast the long-term risk of moderate or severe fibrosis. (C) 2008 Elsevier Ltd. All rights reserved.
引用
收藏
页码:2587 / 2599
页数:13
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