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
Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 1/2016

01-01-2016 | Original Article

Survival and local control rates of triple-negative breast cancer patients treated with boost-IOERT during breast-conserving surgery

Authors: Gerd Fastner, MD, Cornelia Hauser-Kronberger, MD, Angelika Moder, PhD, Roland Reitsamer, MD, Franz Zehentmayr, MD, Peter Kopp, PhD, Christoph Fussl, MD, Thorsten Fischer, MD, Heinrich Deutschmann, MSc, Felix Sedlmayer, MD

Published in: Strahlentherapie und Onkologie | Issue 1/2016

Login to get access

Abstract

Aim

The purpose of this work was to retrospectively evaluate survival and local control rates of triple-negative breast cancer subtypes classified as five marker negative (5NP) and core basal (CB), respectively, after breast-conserving surgery and intraoperative boost radiotherapy with electrons (IOERT) followed by whole breast irradiation.

Methods and materials

A total of 71 patients with triple-negative breast cancer were enrolled, who were treated with lumpectomy, axillary lymph node dissection, and IOERT with 9.6 Gy (median Dmax) followed by normofractionated whole breast irradiation to median total doses of 54 Gy. Chemotherapy was applied in a neoadjuvant (12 %), adjuvant (75 %), or combinational setting (7 %).

Results

After a median follow-up of 97 months (range 4–170 months), 5 in-breast recurrences were detected (7.0 %). For all patients, 8-year actuarial rates for local control, metastases-free survival, disease-specific survival, and overall survival amounted to 89, 75, 80, and 69 %, respectively. All local recurrences occurred in grade 3 (G3) tumors irrespective of their specific immunohistochemical phenotype; thus, the local control rate for grades 1/2 (G1/2) was 100 % for both 5NP and CB, while for G3 it was 88 % for 5NP and 90 % for CB (p = 0.65 and 0.82, respectively, n.s.). For disease-specific survival, only the difference of the best-prognosis group 5-NP/G3 vs. the worst-prognosis cohort CB/G1/2 was statistically significant: 90 % vs. 54 % (p = 0.03).

Conclusion

Boost-IOERT provides acceptable long-term in-breast control in triple negative breast cancer. The best subgroup in terms of disease-specific survival was represented by 5NP in combination with tumor grading G3.
Footnotes
1
In-breast and regional recurrences together
 
Literature
1.
Goldhirsch A, Winer EP, Coates AS et al (2013) Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol 24:2206–2223PubMedPubMedCentralCrossRef
2.
Lowery AJ, Kell MR, Glynn RW et al (2012) Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res Treat 133:831–841PubMedCrossRef
3.
Lehmann BD, Bauer JA, Chen X et al (2011) Identification of human triple-negative breast cancer subtypes and preclinical models for selection of targeted therapies. J Clin Invest 121:2750–2767PubMedPubMedCentralCrossRef
4.
5.
Peddi PF, Ellis MJ, Ma C (2012) Molecular basis of triple negative breast cancer and implications for therapy. Int J Breast Cancer 2012:217185. doi:10.1155/2012/217185PubMedPubMedCentralCrossRef
6.
Cheang MC, Voduc D, Bajdik C et al (2008) Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype. Clin Cancer Res 14:1368–1376PubMedCrossRef
7.
Cho EY, Chang MH, Choi YL et al (2011) Potential candidate biomarkers for heterogeneity in triple-negative breast cancer (TNBC). Cancer Chemother Pharmacol 68:753–761PubMedCrossRef
8.
Uhm JE, Park YH, Yi SY et al (2009) Treatment outcomes and clinicopathologic characteristics of triple-negative breast cancer patients who received platinum-containing chemotherapy. Int J Cancer 124:1457–1462PubMedCrossRef
9.
Sedlmayer F, Sautter-Bihl ML, Budach W et al (2013) DEGRO practical guidelines: radiotherapy of breast cancer I: radiotherapy following breast conserving therapy for invasive breast cancer. Strahlenther Onkol 189:825–833PubMedPubMedCentralCrossRef
10.
Bartelink H, Maingon P, Poortmans P et al (2015) Whole-breast irradiation with or without a boost for patients treated with breast-conserving surgery for early breast cancer: 20-year follow-up of a randomised phase 3 trial. Lancet Oncol 16:47–56PubMedCrossRef
11.
Reitsamer R, Sedlmayer F, Kopp M et al (2006) The Salzburg concept of intraoperative radiotherapy for breast cancer: results and considerations. Int J Cancer 118:2882–2887PubMedCrossRef
12.
Sedlmayer F, Fastner G, Merz F et al (2007) IORT with electrons as boost strategy during breast conserving therapy in limited stage breast cancer: results of an ISIORT pooled analysis. Strahlenther Onkol 183:32–34PubMedCrossRef
13.
Krengli M, Calvo FA, Sedlmayer F et al (2013) Clinical and technical characteristics of intraoperative radiotherapy. Analysis of the ISIORT-Europe database. Strahlenther Onkol 189:729–737PubMedCrossRef
14.
Fastner G, Sedlmayer F, Merz F et al (2013) IORT with electrons as boost strategy during breast conserving therapy in limited stage breast cancer: long term results of an ISIORT pooled analysis. Radiother Oncol 108:279–286PubMedCrossRef
15.
Kaplan EL, Meier P (1958) Nonparametric-Estimation from Incomplete Observations. J Am Stat Assoc 53:457–481CrossRef
16.
Voduc KD, Cheang MC, Tyldesley S et al (2010) Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol 28:1684–1691PubMedCrossRef
17.
Millar EK, Graham PH, O’Toole SA et al (2009) Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel. J Clin Oncol 27:4701–4708PubMedCrossRef
18.
Elsawaf Z, Sinn HP, Rom J et al (2013) Biological subtypes of triple-negative breast cancer are associated with distinct morphological changes and clinical behaviour. Breast 22:986–992PubMedCrossRef
19.
Luporsi E, Andre F, Spyratos F et al (2012) Ki-67: level of evidence and methodological considerations for its role in the clinical management of breast cancer: analytical and critical review. Breast Cancer Res Treat 132:895–915PubMedPubMedCentralCrossRef
20.
Vaidya JS, Baldassarre G, Massarut S (2009) Beneficial effects of intraoperative radiotherapy on tumor microenvironment could improve outcomes (Int J Radiat Oncol Biol Phys 2008;72:1575–1581). Int J Radiat Oncol Biol Phys 74:976PubMedCrossRef
21.
Belletti B, Vaidya JS, D’Andrea S et al (2008) Targeted intraoperative radiotherapy impairs the stimulation of breast cancer cell proliferation and invasion caused by surgical wounding. Clin Cancer Res 14:1325–1332PubMedCrossRef
22.
Herskind C, Griebel J, Kraus-Tiefenbacher U et al (2008) Sphere of equivalence—a novel target volume concept for intraoperative radiotherapy using low-energy X rays. Int J Radiat Oncol Biol Phys 72:1575–1581PubMedCrossRef
23.
Pogoda K, Niwinska A, Murawska M et al (2013) Analysis of pattern, time and risk factors influencing recurrence in triple-negative breast cancer patients. Med Oncol 30:388PubMedPubMedCentralCrossRef
24.
Montagna E, Bagnardi V, Rotmensz N et al (2012) Breast cancer subtypes and outcome after local and regional relapse. Ann Oncol 23:324–331PubMedCrossRef
25.
Nguyen PL, Taghian AG, Katz MS et al (2008) Breast cancer subtype approximated by estrogen receptor, progesterone receptor, and HER-2 is associated with local and distant recurrence afte breast-conserving therapy. J Clin Oncol 26:2373–2378PubMedCrossRef
26.
Moran MS (2015) Radiation therapy in the locoregional treatment of triple-negative breast cancer. Lancet Oncol 16:e113–e122CrossRef
27.
Zaky SS, Lund M, May KA et al (2011) The negative effect of triple-negative breast cancer on outcome after breast-conserving therapy. Ann Surg Oncol 18:2858–2865PubMedCrossRef
28.
Cortazar P, Zhang L, Untch M et al (2014) Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 384:164–172PubMedCrossRef
Metadata
Title
Survival and local control rates of triple-negative breast cancer patients treated with boost-IOERT during breast-conserving surgery
Authors
Gerd Fastner, MD
Cornelia Hauser-Kronberger, MD
Angelika Moder, PhD
Roland Reitsamer, MD
Franz Zehentmayr, MD
Peter Kopp, PhD
Christoph Fussl, MD
Thorsten Fischer, MD
Heinrich Deutschmann, MSc
Felix Sedlmayer, MD
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 1/2016
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-015-0895-2

Other articles of this Issue 1/2016

Strahlentherapie und Onkologie 1/2016 Go to the issue

Original Article

Hyperfractionated stereotactic reirradiation for recurrent head and neck cancer

Literatur kommentiert

Akuttoxizität nach hypofraktionierter versus konventionell fraktionierter Strahlentherapie bei Patienten mit Prostatakarzinom

Original Article

Comparative treatment planning study on sequential vs. simultaneous integrated boost in head and neck cancer patients

Original Article

Risk profile for osteoradionecrosis of the mandible in the IMRT era

Original Article

Hedgehog pathway inhibitor in combination with radiation therapy for basal cell carcinomas of the head and neck

Literatur kommentiert

Die stereotaktische Strahlentherapie unterstützt die Immunantwort