[an error occurred while processing this directive] | [an error occurred while processing this directive]
Investigation and analysis of thereasons for omission of adjuvant radiotherapy after breast-conserving surgery for early-stage breast cancer
Cui Xiaoying1, Sheng Liming2, Ji Yongling2, Chen Ying2, Cheng Lei2, Qiu Guoqin2, Zhou Xia2, Bao Wuan2, Yang Yang2, Yang Hongjian3, Du Xianghui2
1The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053,China; 2Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China; 3Department of Breast Cancer Surgery, Zhejiang Cancer Hospital, Hangzhou 310022,China
AbstractObjective To investigate and analyze the reasons for the omission of adjuvant radiotherapy after breast-conserving surgery (BCS) in patients with breast cancer.Methods The clinicopathologial characteristics and socioeconomic data of 55 breast cancer patients undergoing BCS without postoperative adjuvant radiotherapy in our hospital from 2012 to 2016 were retrospectively analyzed.Results Among the 55 patients who did not receive radiotherapy, 25 patients were due to low local recurrence risk,12 patients were due to economic or family reasons,12 patients were due to fear of adverse reactions of radiotherapy, and 5 patients were not recommended by primary physicians for radiotherapy.In addition, 3 cases with multiple distant metastases and 3 cases with concomitant thyroid cancer didn't received radiotherapy.Conclusions Low risk local recurrence is the main reason for the omission of adjuvant radiotherapy, followed by the fear of radiation-induced toxicity and poor financial support. Patient education and medical insurance may improve the adjuvant radiotherapy compliance.
Corresponding Authors:
Du Xianghui,Email:duxianghui@aliyun.com;Yang Hongjian, Email:yanghj@zjcc.org.cn
Cite this article:
Cui Xiaoying,Sheng Liming,Ji Yongling et al. Investigation and analysis of thereasons for omission of adjuvant radiotherapy after breast-conserving surgery for early-stage breast cancer[J]. Chinese Journal of Radiation Oncology, 2019, 28(6): 421-424.
Cui Xiaoying,Sheng Liming,Ji Yongling et al. Investigation and analysis of thereasons for omission of adjuvant radiotherapy after breast-conserving surgery for early-stage breast cancer[J]. Chinese Journal of Radiation Oncology, 2019, 28(6): 421-424.
[1] 邵志敏.乳腺外科的回顾与展望[J].上海医学,2017,40(8):462-465. Shao ZM.Review and prospect of breast surgery[J].Shanghai Med,2017,40(8):462-465. [2] Struikmans H,Aarts MJ,Jobsen JJ, et al. An increased utilisation rate and better compliance to guidelines for primary radiotherapy for breast cancer from 1997 till 2008:a population-based study in the Netherlands[J].RadiotherOncol, 2011,99(2):320-325. DOI:10.1016/j.radonc.2011.05.012. [3] 王淑莲,李晔雄,张保宁等.1999-2008年中国大陆地区乳腺癌保乳术及术后放疗情况的临床流行病学研究[J].中华放射肿瘤学杂志,2013,22(6):427-432.DOI:10.3760/cma.j.issn.1004-4221.2013.06.001. Wang SL,Li YX,Zhang BN,et al. Clinical epidemiological study on breast protection and postoperative radiotherapy in mainland China in the 1999-2008[J].ChinJRadiat Oncol,2013,22(6):427-432.DOI:10.3760/cma.j.issn.1004-4221.2013.06.001. [4] Palta M, Palta P, Bhavsar NA, et al. The use of adjuvant radiotherapy in elderly patients with early-stage breast cancer:changes in practice patterns after publication of Cancer and Leukemia Group B 9343[J].Cancer, 2015,121(2):188-193. DOI:10.1002/cncr.28937. [5] Chesney TR, Yin JX, Rajaee N, et al. Tamoxifen with radiotherapy compared with Tamoxifen alone in elderly women with early-stage breast cancer treated with breast conserving surgery:a systematic review and meta-analysis[J].RadiotherOncol, 2017,123(1):1-9. DOI:10.1016/j.radonc.2017.02.019. [6] WapnirI L,Dignam JJ,Fisher B,et al. Long term outcomes of invasive ipsilateral breast cancer tumor recurrences after lumpectomy in NSABP B-17 and B-24 randomized clinical trials for DCIS[J].J NatiCancer Inst,2011,103(3):478-488.DOI:10.1093/jnci/djr027. [7] Warnberg F,Garmo H,Emdin S,et al. Effect of radiotherapy after breast-conserving surgery for ductal carcinoma in situ:20 years follow-up in randomized SweDCIS Trial[J].J Clin Oncol,2014,32(32):3613-3618.DOI:10.1200/JCO.2014.56.2595. [8] Julien JP,Bijker N,FentimanI,et al. Radiotherapy in breast conserving treatment for ductal carcinoma in situ:first results of EORTC randomized phase Ⅲ trial 10853[J].Lancet,2000,355(9203):528-533.DOI:10.1016/S0140-6736(99)06341-2. [9] Houghton J,George WD,Cuzick J,et al. Radiotherapy and tamoxifen in women with completely excised ductal carcinoma in situ of the breast in the UK,Australia,and New Zealand:randomized controlled trial[J].Lancet,2003,362(9378):95-102.DOI:10.1016/S0140-6736(03)14476-5. [10] Solin LJ,Gray R,Hughes LL,et al. Surgical excision without radiation for ductal carcinoma in situ of the breast 12-year results from the ECOG-ACRIN E5194 study[J].J Clin Oncol,2015,33(33):3938-3944.DOI:10.1200/JCO.2015.60.8588. [11] Mc Comick B,Winter K,Hudis C,et al. RTOG 9804:a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation[J].J Clin Oncol,2015,33(4):709-715.DOI:10.1200/JCO.2014.57.9029. [12] Bengala C,Zamagni C,Pedrazzoli P,et al. Cardiac toxicity of trastuzumab in metastatic breast cancer patients previously treated with high-dose chemotherapy:a retrospective study[J].Br J Cancer,2006,94(7):1016-1020.DOI:10.1038/sj.bjc.6603060. [13] Gabrys D,Piela A,Walaszczyk R,et al. Cardiac toxicity after breast cancer patients treatment[J].Radiother Oncol,2016,119(1):s567.