Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in: Radiation Oncology 1/2010

Open Access 01-12-2010 | Research

Is standard breast-conserving therapy (BCT) in elderly breast cancer patients justified? A prospective measurement of acute toxicity according CTC-classification

Authors: Razvan M Galalae, Jürgen Schultze, Kirsten Eilf, Bernhard Kimmig

Published in: Radiation Oncology | Issue 1/2010

Login to get access

Abstract

Background

Breast conserving therapy (BCT) is an accepted treatment for early-stage breast cancer. This study aimed to measure prospectively acute radiation-related toxicity and to create a comprehensive data base for long-term temporal analyses of 3D conformal adjuvant radiotherapy. The specific aspect of age has been neglected by traditional research. Therefore, the impact of age on acute BCT toxicity should be also specifically adressed.

Methods

Toxicity was measured in 109 patients at initiation (t1), during radiotherapy (t2-t7), and 6 weeks after treatment completion (t8) using a new topographic module. Organ systems were recorded in 15 scales and scored according to symptom intensity (grade 0-5) based on CTC (Common Toxicity Criteria) -classification. Radiotherapy was virtually CT-based planned and applied with 6-MeV-photons. Mean total dose was 60.1 Gy. Patients were stratified by age in 3 Groups: <50, 50-60, and >60 years.

Results

Registered toxicity was generally low. Mean overall-grade climbed from 0.29-0.40 (t1-t7), and dropped to 0.23 (t8). Univariate analyses revealed slightly higher toxicity in older (> 60 years) versus young patients (< 50 years) in 2 scales only: breast-symmetry (p = 0.033), and arm function (p = 0.007). However, in the scale "appetite" toxicity was higher in younger (< 50 years) versus older (> 60 years) patients (p = 0.039). Toxicity differences in all other scales were not significant. Between older (> 60 years) and midaged patients (50-60 years) no significant differences in toxicity were found. This was also true for the comparison between young (< 50 years) versus midaged patient groups (50-60 years).

Conclusion

The treatment concept of BCT for breast cancer is generally well tolerated. The toxicity-measurement with the new topographic module is feasible. Not modified standard treatment for BC should be performed in elderly women.
Appendix
Available only for authorised users
Literature
1.
Bland KI, Menck HR, Scott-Conner CE, et al.: The National Cancer Database 10-year survey of breast carcinoma treatment at hospitals in the United States. Cancer 1998, 83: 1262-1273. 10.1002/(SICI)1097-0142(19980915)83:6<1262::AID-CNCR28>3.0.CO;2-2CrossRefPubMed
2.
Chung M, Chang HR, Bland KI, et al.: Younger women with breast carcinoma have a poorer prognosis than older women. Cancer 1996, 77: 97-103. 10.1002/(SICI)1097-0142(19960101)77:1<97::AID-CNCR16>3.0.CO;2-3CrossRefPubMed
3.
El Saghir NS, Seoud M, Khalil MK, et al.: Effects of young age at presentation on survival in breast cancer. BMC Cancer 2006, 6: 194. 10.1186/1471-2407-6-194PubMedCentralCrossRefPubMed
4.
Gnerlich JL, Deshpande AD, et al.: Elevated Breast Cancer Mortality in Women Younger than Age 40 Years Compared with Older Women Is Attributed to Poorer Survival in Early-Stage Disease. J Am Coll Surg 2009,208(3):341-347. 10.1016/j.jamcollsurg.2008.12.001PubMedCentralCrossRefPubMed
5.
Sweeney C, Schmitz KH, Lazovich D, et al.: Functional limitations in elderly female cancer survivors. J Natl Cancer Inst 2006, 98: 521-9. 10.1093/jnci/djj130CrossRefPubMed
6.
Watters JM, Yau JC, O'Rourke K, Tomiak E, Gertler SZ: Functional status is well maintained in older women during adjuvant chemotherapy for breast cancer. Ann Oncol 2003, 14: 1744-50. 10.1093/annonc/mdg497CrossRefPubMed
7.
Fredriksson I, Liljegren G, Arnesson LG, et al.: Consequences of axillary recurrence after conservative breast surgery. Br J Surg 2002,89(7):902-8. 10.1046/j.1365-2168.2002.02117.xCrossRefPubMed
8.
Cochrane RA, Valasiadou P, Wilson AR, et al.: Cosmesis and satisfaction after breast-conserving surgery correlates with the percentage of breast volume excised. Br J Surg 2003,90(12):1505-9. 10.1002/bjs.4344CrossRefPubMed
9.
Seegenschmiedt MH: Interdisciplinary documentation of treatment side effects in oncology. Present status and perspectives. Strahlenther Onkol 1998,174(Suppl 3):25-9.PubMed
10.
(NCI) National Cancer Institute: Common Toxicity Criteria (CTC). National Cancer Institute, Washington; 1988.
11.
Niehoff P, Galalae R, Zimmermann JS, Kimmig K: Electronical recording and evaluation of acute radiation morbidity. Strahlenther Onkol 1998,174(Suppl 3):37-9.PubMed
12.
Zimmermann JS, Seegenschmiedt MH, Niehoff P, Galalae R, Kimmig K: Topographic documentation of acute radiation morbidity. Strahlenther Onkol 1998,174(Suppl 3):30-6.PubMed
13.
Yanik R, Ries LG, Yates JW: Breast Cancer in Aging Women: A Population-Based Study of Contrasts in Stage, Surgery, and Survival. Cancer 1989, 63: 976-981. 10.1002/1097-0142(19890301)63:5<976::AID-CNCR2820630532>3.0.CO;2-ACrossRef
14.
Jackson LC, Camacho F, Levine EA, et al.: Patterns of care analysis among women with ductal carcinoma in situ in North Carolina. Am J Surg 2008,195(2):164-9. 10.1016/j.amjsurg.2007.10.001CrossRefPubMed
15.
Bidgood WD Jr, Horii SC, Prior FW, et al.: Understanding and using DICOM, the data interchange standard for biomedical imaging. J Am Med Inform Assoc 1997, 4: 199-212.PubMedCentralCrossRefPubMed
16.
Landberg T, Chavaudra J, Dobbs J, et al.: ICRU (International Commission of Radiation Units and Measurements) Report No. 50: Prescribing, Recording, and Reporting Photon Beam Therapy. International Commission of Radiation Units and Measurements, Washington, DC; 1993.
17.
Hermanek P, Hutter RVP, Sobin LH, et al.: Union internationale contre le cancer (UICC): TNM/pTNM-Klassifikation maligner Tumoren. 4. Auflage, Springer-Verlag, Berlin-Heidelberg-New-York; 1998.
18.
Karnofsky DA, Burchenal JH: The clinical evaluation of chemotherapeutic agents in cancer, in evaluation of chemotherapeutic agents. Edited by: Mc Leod CM. Columbia University Press, New-York; 1949:191-205.
19.
Vicini FA, Sharpe M, Kestin L, et al.: Optimizing breast cancer treatment efficacy with intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 2002,54(5):1336-44.CrossRefPubMed
20.
Gruber G, Berclaz G, Altermatt HJ, Greiner RH: Can the addition of regional radiotherapy counterbalance important risk factors in breast cancer patients with extracapsular invasion of axillary lymph node metastases? Strahlenther Onkol 2003, 179: 661-6. 10.1007/s00066-003-1084-2CrossRefPubMed
21.
Albrecht MR, Zink K, Busch W, Ruhl U: Dissection or irradiation of the axilla in postmenopausal patients with breast cancer? Long-term results and long-term effects in 655 patients. Strahlenther Onkol 2002,178(9):510-6. 10.1007/s00066-002-1035-3CrossRefPubMed
22.
Nagel G, Rohrig B, Hoyer H, et al.: A population-based study on variations in the use of adjuvant radiotherapy in breast cancer patients. Strahlenther Onkol 2002, 178: 589-96. 10.1007/s00066-002-0985-9CrossRefPubMed
Metadata
Title
Is standard breast-conserving therapy (BCT) in elderly breast cancer patients justified? A prospective measurement of acute toxicity according CTC-classification
Authors
Razvan M Galalae
Jürgen Schultze
Kirsten Eilf
Bernhard Kimmig
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2010
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-5-103

Other articles of this Issue 1/2010

Radiation Oncology 1/2010 Go to the issue

Research

Stereotactic radiosurgery may contribute to overall survival for patients with recurrent head and neck carcinoma

Research

Comparison of coplanar and noncoplanar intensity-modulated radiation therapy and helical tomotherapy for hepatocellular carcinoma

Research

Long-term results from a randomized phase II trial of neoadjuvant combined-modality therapy for locally advanced rectal cancer

Research

Consequential late effects after radiotherapy for prostate cancer - a prospective longitudinal quality of life study

Research

Dosimetric comparison using different multileaf collimeters in intensity-modulated radiotherapy for upper thoracic esophageal cancer

Research

Prospective evaluation of microscopic extension using whole-mount preparation in patients with hepatocellular carcinoma: Definition of clinical target volume for radiotherapy