Predictors of the risk of fibrosis at 10 years after breast conserving therapy for early breast cancer - A study based on the EORTC trial 22881-10882 'boost versus no boost'

Sandra Collette*, Laurence Collette, Tom Budiharto, Jean-Claude Horiot, Philip M. Poortmans, Henk Struikmans, Walter Van den Bogaer, Alain Fourquet, Jos J. Jagerg, Willem Hoogenraad, Rolf-Peter Mueller, John Kurtz, David A. L. Morgan, Jean-Bernard Dubois, Emile Salamon, Rene Mirimanoff, Michel Bolla, Marleen Van der Hulst, Carla C. Warlam-Rodenhuis, Harry BartelinkEORTC Radiation Oncology Grp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

146 Citations (Scopus)

Abstract

The EORTC 22881-10882 trial in 5178 conservatively treated early breast cancer patients showed that a 16 Gy boost dose significantly improved local control, but increased the risk of breast fibrosis. To investigate predictors for the long-term risk of fibrosis, Cox regression models of the time to moderate or severe fibrosis were developed on a random set of 1797 patients with and 1827 patients without a boost, and validated in the remaining set. The median follow-up was 10.7 years. The risk of fibrosis significantly increased (P <0.01) with increasing maximum whole breast irradiation (WBI) dose and with concomitant chernotherapy, but was independent of age. In the boost arm, the risk further increased (P <0.01) if patients had post-operative breast oedema or haematoma, but it decreased (P <0.01) if WBI was given with >6 MV photons. The c-index was around 0.62. Nomograms with these factors are proposed to forecast the long-term risk of moderate or severe fibrosis. (C) 2008 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)2587-2599
Number of pages13
JournalEuropean Journal of Cancer
Volume44
Issue number17
DOIs
Publication statusPublished - Nov-2008

Keywords

  • Fibrosis
  • Breast conserving treatment
  • Boost irradiation
  • Nomograms
  • Early breast cancer
  • 20-YEAR FOLLOW-UP
  • QUALITY-OF-LIFE
  • RANDOMIZED-TRIAL
  • LOCAL-CONTROL
  • CONSERVATION THERAPY
  • RADICAL-MASTECTOMY
  • RECURRENCE
  • IMPACT
  • RADIOTHERAPY
  • TAMOXIFEN

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