Dataset Information

Effects of Radiotherapy in Early-Stage, Low-Recurrence Risk, Hormone-Sensitive Breast Cancer.

ABSTRACT:

Background

Radiotherapy after breast conservation has become the standard of care. Prior meta-analyses on effects of radiotherapy predated availability of gene expression profiling (GEP) to assess recurrence risk and/or did not include all relevant outcomes. This analysis used GEP information with pooled individual-level data to evaluate the impact of omitting radiotherapy on recurrence and mortality.

Methods

We considered trials that evaluated or administered radiotherapy after lumpectomy in women with low-risk breast cancer. Women included had undergone lumpectomy and were treated with hormonal therapy for stage I, ER+ and/or PR+, HER2- breast cancer with Oncotype scores no greater than 18. Recurrence-free interval (RFI), type of RFI (locoregional or distant), and breast cancer-specific and overall survival were compared between no radiotherapy and radiotherapy using adjusted Cox models. All statistical tests were two-sided.

Results

The final sample included 1778 women from seven trials. Omission of radiotherapy was associated with an overall adjusted hazard ratio of 2.59 (95% confidence interval [CI] = 1.38 to 4.89, P?=?.003) for RFI. There was a statistically significant increase in any first locoregional recurrence (P?=?.001), but not distant recurrence events (P?=?.90), or breast cancer-specific (P?=?.85) or overall survival (P?=?.61). Five-year RFI rate was high (93.5% for no radiotherapy vs 97.9% for radiotherapy; absolute reduction?=?4.4%, 95% CI = 0.7% to 8.1%, P?=?.03). The effects of radiotherapy varied across subgroups, with lower RFI rates for those with Oncotype scores of less than 11 (vs 11-18), older (vs younger), and ER+/PR+ status (vs other).

Conclusions

Omission of radiotherapy in hormone-sensitive patients with low recurrence risk may lead to a modest increase in locoregional recurrence event rates, but does not appear to increase the rate of distant recurrence or death.

SUBMITTER: Jayasekera J

PROVIDER: S-EPMC6292790 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Publications

Effects of Radiotherapy in Early-Stage, Low-Recurrence Risk, Hormone-Sensitive Breast Cancer.

Jayasekera Jinani J Schechter Clyde B CB Sparano Joseph A JA Jagsi Reshma R White Julia J Chapman Judith-Anne W JW Whelan Timothy T Anderson Stewart J SJ Fyles Anthony W AW Sauerbrei Willi W Zellars Richard C RC Li Yisheng Y Song Juhee J Huang Xuelin X Julian Thomas B TB Luta George G Berry Donald A DA Feuer Eric J EJ Mandelblatt Jeanne J

Journal of the National Cancer Institute 20181201 12

<h4>Background</h4>Radiotherapy after breast conservation has become the standard of care. Prior meta-analyses on effects of radiotherapy predated availability of gene expression profiling (GEP) to assess recurrence risk and/or did not include all relevant outcomes. This analysis used GEP information with pooled individual-level data to evaluate the impact of omitting radiotherapy on recurrence and mortality.<h4>Methods</h4>We considered trials that evaluated or administered radiotherapy after l ...[more]

PMID: 30239794

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Dataset Information

Effects of Radiotherapy in Early-Stage, Low-Recurrence Risk, Hormone-Sensitive Breast Cancer.

Background

Methods

Results

Conclusions

Publications

Effects of Radiotherapy in Early-Stage, Low-Recurrence Risk, Hormone-Sensitive Breast Cancer.

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