Radiation Treatments After Breast-Conserving Therapy for Elderly Patients
Menée sur 636 femmes âgées d'au moins 70 ans et atteintes d'un cancer du sein ER+ de stade T1N0M0 (durée médiane de suivi : 12,6 ans), cette étude évalue, du point de vue du taux de mastectomie, de la survie spécifique et de la survie globale, l'intérêt d'une radiothérapie adjuvante après une tumorectomie combinée à un traitement par tamoxifène
Radiation treatments play an important role in the multidisciplinary management of most patients with breast cancer. Data from prospective phase III trials indicate that, for patients treated with a breast-conserving surgery, radiation reduces the risk of local recurrence, provides a clinically significant reduction in distant metastases, and improves overall survival.
Radiation treatments are also well-tolerated and, when delivered using modern technologies, carry a low risk of serious morbidity. However, there are also down sides to radiation treatments, most important of which are the inconvenience andcostsassociatedwithdailytreatmentsthatareadministeredovera 3- to 6- week period. Therefore, it would be ideal to identify favorable subgroups of patients treated with breast conservation for whom radiation could be avoided. In the past two decades, several randomized trials attempted to do this, but unfortunately most of these trials were unsuccessfulatidentifyingagoodrisksubsetthatcouldbespared radiation. One notable exception was the Cancer and Leukemia GroupB(CALGB)9343trial, whichfoundthatpatientsolderthanage 70 with stage I, estrogen receptor (ER) –positive breast cancer who were treated with surgery and adjuvant tamoxifen without breastirradiation had a low 5-year local recurrence rate. In the article that accompanies this editorial, Hughes et al report the 10-year results of this study...
Journal of Clinical Oncology , éditorial en libre accès, 2013