Radiation dermatitis occurs in approximately 95% of patients receiving radiotherapy (RT) for breast cancer. We conducted a randomized, double-blind, placebo-controlled clinical trial to assess the ability of curcumin to reduce radiation dermatitis severity in 30 breast cancer patients. Eligible patients were adult females with noninflammatory breast cancer or carcinoma in situ prescribed RT without concurrent chemotherapy. Randomized patients took 2.0 grams of curcumin or placebo orally three times per day (i.e., 6.0 grams daily) throughout their course of RT. Weekly assessments included Radiation Dermatitis Severity (RDS) score, presence of moist desquamation, redness measurement, McGill Pain Questionnaire-Short Form and Symptom Inventory questionnaire. The 30 evaluable patients were primarily white (90%) and had a mean age of 58.1 years. Standard pooled variances t test showed that curcumin reduced RDS at end of treatment compared to placebo (mean RDS =2.6 vs. 3.4; P =0.008). Fisher’s exact test revealed that fewer curcumin-treated patients had moist desquamation (28.6% vs. 87.5%; P =0.002). No significant differences were observed between arms for demographics, compliance, radiation skin dose, redness, pain or symptoms. In conclusion, oral curcumin, 6.0 g daily during radiotherapy, reduced the severity of radiation dermatitis in breast cancer patients.

No abstract

Oncotype DX (Genomic Health, Redwood City, CA, USA, current list price $4,350.00) is a multigene quantitative reverse transcription-polymerase chain reaction-based assay that estimates the risk of distant recurrence and predicts chemotherapy benefit for patients with estrogen receptor (ER)-positive breast cancers. Studies have suggested that standard histologic variables can provide similar information. Klein and Dabbs et al have shown that Oncotype DX recurrence scores can be estimated by incorporating standard histologic variables into equations (Magee equations). Using a simple modification of the Magee equation, we predict the Oncotype DX recurrence score in an independent set of 283 cases. The Pearson correlation coefficient (r) for the Oncotype DX and average modified Magee recurrence scores was 0.6644 (n = 283; Po 0.0001). 100% of cases with an average modified Magee recurrence score430 (n = 8) or an average modified Magee recurrence score o9 (with an available Ki-67, n = 5) would have been correctly predicted to have a high or low Oncotype DX recurrence score, respectively. 86% (38/44) of cases with an average modified Magee recurrence score ≤ 12, and 89% (34/38) of low grade tumors (NS o6) with an ER and PR ≥ 150, and a Ki-67 o 10%, would have been correctly predicted to have a low Oncotype DX recurrence score. Using an algorithmic approach to eliminate high and low risk cases, between 5% and 23% of cases would potentially not have been sent by our institution for Oncotype DX testing, creating a potential cost savings between $56,550.00 and $282,750.00. The modified Magee recurrence score along with histologic criteria may be a cost-effective alternative to the Oncotype DX in risk stratifying certain breast cancer patients. The information needed is already generated by many pathology laboratories during the initial assessment of primary breast cancer, and the equations are free. Breast cancer is the most common non-cutaneous cancer in women, and the second most frequent cause of cancer death among women. 1 Approximately 50% of breast cancer cases are estrogen receptor (ER)-positive. 2 A major challenge in the treatment planning for breast cancer is to identify those patients who are more likely to develop recurrence, so that the most appropriate therapeutic regimen can be provided. The decisions around systemic therapy in breast cancer have traditionally been based on combinations of clinical and histopathologic risk factors including measures of proliferation, 3 tumor size, 4 histologic grade, 5 as well as lymph node staging. 6 In addition, breast cancer biomarkers including ER, progesterone receptor (PR), and the human epidermal growth factor receptor-2 (HER-2), are routinely assessed to provide further prognostic information as well as to help identify subsets of patients who are appropriate for specific targeted therapies. 7-9 These prognostic markers are very useful for identifying the higher risk triple negative or HER-2-positive cases; however, it remains challenging to accurately assess individ...

Both calcitriol and exercise were shown to be feasible and well tolerated. Calcitriol significantly improved bone formation, resulting in a net increase of bone metabolism. Compliance with the exercise intervention was sub-optimal, which may have led to a lack of effect of exercise on bone metabolism.