Timing of radiotherapy following breast-conserving surgery: outcome of 1393 patients at a single institution

Background The role of postoperative radiotherapy in breast-conserving therapy is undisputed. However, optimal timing of adjuvant radiotherapy is an issue of ongoing debate. This retrospective clinical cohort study was performed to investigate the impact of a delay in surgery–radiotherapy intervals...

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Published in:Strahlentherapie und Onkologie 2014-04, Vol.190 (4), p.352-357
Main Authors: Corradini, S., Niemoeller, O.M., Niyazi, M., Manapov, F., Haerting, M., Harbeck, N., Belka, C., Kahlert, S.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Breast Neoplasms - mortality
Breast Neoplasms - therapy
Female
Germany - epidemiology
Humans
Mastectomy, Segmental - mortality
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Recurrence, Local - mortality
Neoplasm Recurrence, Local - prevention & control
Oncology
Original Article
Prevalence
Radiotherapy
Radiotherapy, Adjuvant - mortality
Registries
Retrospective Studies
Risk Factors
Survival Analysis
Treatment Outcome
Waiting Lists
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Summary:Background The role of postoperative radiotherapy in breast-conserving therapy is undisputed. However, optimal timing of adjuvant radiotherapy is an issue of ongoing debate. This retrospective clinical cohort study was performed to investigate the impact of a delay in surgery–radiotherapy intervals on local control and overall survival. Patients and methods Data from an unselected cohort of 1393 patients treated at a single institution over a 17-year period (1990–2006) were analyzed. Patients were assigned to two groups (CT+/CT−) according to chemotherapy status. A delay in the initiation of radiotherapy was defined as > 7 weeks (CT− group) and > 24 weeks (CT+ group). Results The 10-year regional recurrence-free survival for the CT− and CT+ groups were 95.6 and 86.0 %, respectively. A significant increase in the median surgery–radiotherapy interval was observed over time (CT− patients: median of 5 weeks in 1990–1992 to a median of 6 weeks in 2005–2006; CT+ patients: median of 5 weeks in 1990–1992 to a median of 21 weeks in 2005–2006). There was no association between a delay in radiotherapy and an increased local recurrence rate (CT− group: p = 0.990 for intervals 0–6 weeks vs. ≥ 7 weeks; CT+ group: p = 0.644 for intervals 0–15 weeks vs. ≥ 24 weeks) or decreased overall survival (CT− group: p = 0.386 for intervals 0–6 weeks vs. ≥ 7 weeks; CT+ group: p = 0.305 for intervals 0–15 weeks vs. ≥ 24 weeks). Conclusion In the present cohort, a delay of radiotherapy was not associated with decreased local control or overall survival in the two groups (CT−/CT+). However, in the absence of randomized evidence, delays in the initiation of radiotherapy should be avoided.
ISSN:0179-7158
1439-099X
DOI:10.1007/s00066-013-0540-x