1
|
Rogé M, Kirova Y, Lévêque E, Guigo M, Johnson A, Nebbache R, Del Campo ER, Lazarescu I, Servagi S, Mervoyer A, Cailleteau A, Thureau S, Thariat J. Impact of radiation therapy modalities on loco-regional control in inflammatory breast cancer. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)00506-6. [PMID: 38621608 DOI: 10.1016/j.ijrobp.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION In inflammatory breast cancer (IBC), radiotherapy intensification is considered a standard of care by some teams, although the level of evidence remains low. We sought to analyze the impact of radiotherapy modalities on the risk of loco-regional and distant relapse. METHODS A retrospective multicenter study included patients with localized IBC treated between 2010 and 2017. Standard post-mastectomy radiotherapy consisted of daily fractions to a total dose of 50 Gy equivalent without a boost or bolus, while intensified radiotherapy referred to the use of a boost or bolus. The cumulative incidence curves of loco-regional and distant recurrence were displayed using the competing risk method. RESULTS Of the 241 included patients, 165 were treated with standard and 76 with intensified radiotherapy. There was significantly more nodal involvement in the intensified group. With a median follow-up of 40 months post-radiotherapy, there was no difference between standard vs intensified radiotherapy regarding the cumulative incidence of loco-regional (p=0.68) or distant recurrence (p=0.29). At 5 years, the risks of loco-regional and distant recurrence were 12.1% (95% CI, 7.5; 17.7) and 29.4% (95% CI, 21.8; 37.3) for patients treated with standard radiotherapy and 10.4% (95% CI, 4.4; 19.3) and 21.4% (95% CI, 12.6; 31.9) for intensified radiotherapy. On multivariate analyses, triple-negative subtype and absence of complete pathological response (pCR) were associated with a higher risk of loco-regional recurrence. Radiotherapy intensification had no significant impact on loco-regional and distant recurrence. For non-pCR patients (n=172, 71.7%), no significant differences were observed between the two groups for loco-regional (p=0.80) and distant recurrence either (p=0.39). Severe toxicity rates were similar in both groups. CONCLUSIONS Contrary to other important series, this large retrospective multicentric study did not show a loco-regional or distant control benefit of intensified radiotherapy. Pooled prospective studies and meta-analyses of intensified radiotherapy are warranted to endorse this approach.
Collapse
Affiliation(s)
- Maximilien Rogé
- Department of Radiation Oncology, Henri Becquerel Cancer Center, Rouen, 76000, France.
| | - Youlia Kirova
- Department of Radiation Oncology, Institut Curie, Paris, 75005, France
| | - Emilie Lévêque
- Unit of Clinical Research, Henri Becquerel Cancer Center, Rouen, 76000, France.
| | - Marin Guigo
- Department of Radiation Oncology, Center François Baclesse, Caen, 14000, France
| | - Alison Johnson
- Department of Medical Oncology, Center François Baclesse, Caen, 14000, France
| | - Rafik Nebbache
- Department of Radiation Oncology, Tenon University Hospital, Sorbonne University, Paris, 75020, France
| | - Eleonor Rivin Del Campo
- Department of Radiation Oncology, Tenon University Hospital, Sorbonne University, Paris, 75020, France
| | - Ioana Lazarescu
- Department of Radiation Oncology, Center de la Baie, Avranches, 50300, France
| | - Stéphanie Servagi
- Department of Radiation Oncology, Institut Jean Godinot, Reims, 51100, France
| | - Augustin Mervoyer
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Saint-Herblain, 44800, France
| | - Axel Cailleteau
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Saint-Herblain, 44800, France
| | - Sébastien Thureau
- Department of Radiation Oncology and Nuclear Medicine, Henri Becquerel Cancer Center, and QuantIF LITIS, Rouen, 76000, France
| | - Juliette Thariat
- Department of Radiation Oncology, Center François Baclesse, Caen, 14000, France
| |
Collapse
|
2
|
Roge M, Salleron J, Kirova Y, Guigo M, Huguet F, Nebbache R, Rivera S, Nunez Baez M, Lazarescu I, Servagi Vernat S, Cailleteau A, Supiot S, Thariat J, Thureau S. Étude Raibeca : radiotherapy for inflammatory breast cancer. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
3
|
Mège A, Biau J, Meyer E, Allouache N, Guigo M, Servagi Vernat S. Les essais cliniques en radiothérapie qui ont changé les pratiques 2010–2020. Cancer Radiother 2020; 24:612-622. [DOI: 10.1016/j.canrad.2020.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 11/25/2022]
|