Adjuvant radiotherapy on older and oldest breast cancer patients after conservative surgery: A retrospective analysis

Fiorica, Francesco; Berretta, Massimiliano; Ursino, Stefano; Fisichella, R; Lleshi, Arben; Fiorica, G; Stefanelli, Antonio; Zini, G.; Tirelli, Umberto; Zanghì, Antonio; Cappellani, Alessandro; Berretta, Salvatore; Cartei, F.

doi:10.1016/j.archger.2011.10.002

Cited by 9 publications

(12 citation statements)

References 21 publications

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“…Population based analyses have confirmed the data presented here: patients older than 69 are more likely not to receive adjuvant radiotherapy than patients in other age groups, even though radiotherapy after BCT optimizes local tumor control in patients of all ages and reduces the recurrence rate (29)(30)(31)(32). Earlier studies investigated the reduction in mortality owing to the use of radiotherapy in older women (33)(34)(35)(36)(37).…”

Section: Study Cohortsupporting

confidence: 77%

The Treatment of Primary Breast Cancer in Older Women With Adjuvant Therapy

Peters¹,

Anzeneder²,

Jackisch³

et al. 2015

Deutsches Ärzteblatt International

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Section: Study Cohortsupporting

confidence: 77%

The Treatment of Primary Breast Cancer in Older Women With Adjuvant Therapy

Peters¹,

Anzeneder²,

Jackisch³

et al. 2015

Deutsches Ärzteblatt International

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“…Patients with no or mild co-morbidities showed a significantly better survival while increasing severity of co-morbidity may sufficiently shorten remaining life expectancy to cancel gains with adjuvant radiotherapy [70]. …”

Section: Resultsmentioning

confidence: 99%

Prognostic factors in elderly patients with breast cancer

et al. 2013

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BackgroundBreast cancer (BC) remains principally a disease of old ages; with 35-50% of cases occurring in women older than 65 years. Even mortality for cancer increases with aging: 19.7% between 65 and 74 years; 22.6% between 75 and 84 years; and 15.1% in 85 years or more.The study was aimed to investigate specific predictive factors for elderly patients so to select the best way to treat and follow these patients.MethodsA search was performed on Medline, Embase, Scopus using the following Key words: Breast cancer, Breast neoplasms, Aged, Elder, Elderly, Eldest, Older, Survival analysis, Prognosis, Prognostic factors, Tumor markers, Biomarkers, Comorbidity, Geriatric assessment, Axilla, Axillary surgery. 3029 studies have been retrieved. Paper in which overall or disease free survival were not end points, or age class was not well defined, or the sample was too small, were excluded. At last 42 papers fulfilled the criteria.Results and discussionLack of screening and delay in diagnosis may be responsible for the minor improvement in survival observed in elderly respect to younger breast cancer patients. Predictive factors are the same and must be assessed with the same attention reserved to younger women.ConclusionsMost of elderly patient are fit to undergo standard treatment and can get the same benefits of younger women. Nevertheless it is possible that some older women with early breast cancer can be spared too aggressive treatments. Geriatric assessment and co-morbidities can affect the prognosis modifying surveillance, life expectancy and compliance to therapies. They can thus be useful to select the better treatment, either surgical or radio or hormone - or chemo-therapy.

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“…Studies have focused on oncological non-compliance treatments, analysing chemotherapy or hormonal therapy or RT in a specific context. Some of the most common topics are breast cancer [ 12 - 16 ] or head and neck cancer [ 17 , 18 ] and insurance status [ 13 , 14 , 17 - 20 ], which is related with the hospital type or about elderly patients [ 16 , 18 , 21 ]. A global study directed at analysing the duration of curative RT has also been published [ 22 ], but it was aimed at evaluating ways to counteract short RT interruptions, such as those caused by public holidays or machine maintenance.…”

Section: Discussionmentioning

confidence: 99%

“…Despite results showing a significant slightly younger age for non-compliant patients, the difference has no clinical relevance but is explained by a the younger age of palliative patients. This is an important finding because some studies have associated advanced age with lower frequency of definitive or adequate cancer treatment in some studies [ 23 , 24 ] even though other studies suggest that older patients can benefit similarly to younger patients [ 25 , 26 ] with high rates of irradiation completion [ 16 , 18 , 21 ]. It is important to keep one’s mind on carrying out an accurate comprehensive geriatric assessment because there is a possibility of declining functional status [ 27 ] or even an early death [ 28 ] due to cancer treatment in older patients.…”

Section: Discussionmentioning

confidence: 99%

Quality assurance in radiotherapy: analysis of the causes of not starting or early radiotherapy withdrawal

et al. 2014

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BackgroundThe aim of this study was to analyse the reasons for not starting or for early of radiotherapy at the Radiation Oncology Department.MethodsAll radiotherapy treatments from March 2010 to February 2012 were included. Early withdrawals from treatment those that never started recorded. Clinical, demographic and dosimetric variables were also noted.ResultsFrom a total of 3250 patients treated and reviewed, 121 (4%) did not start or complete the planned treatment. Of those, 63 (52%) did not receive any radiotherapy fraction and 58 (48%) did not complete the course, 74% were male and 26% were female. The mean age was 67 ± 13 years. The most common primary tumour was lung (28%), followed by rectum (16%). The aim of treatment was 62% radical and 38% palliative, 44% of patients had metastases; the most common metastatic site was bone, followed by brain. In 38% of cases (46 patients) radiotherapy was administered concomitantly with chemotherapy (10 cases (22%) were rectal cancers).The most common reason for not beginning or for early withdrawal of treatment was clinical progression (58/121, 48%). Of those, 43% died (52/121), 35 of them because of the progression of the disease and 17 from other causes. Incomplete treatment regimens were due to toxicity (12/121 (10%), of which 10 patients underwent concomitant chemotherapy for rectal cancer).ConclusionsThe number of patients who did not complete their course of treatment is low, which shows good judgement in indications and patient selection. The most common reason for incomplete treatments was clinical progression. Rectal cancer treated with concomitant chemotherapy was the most frequent reason of the interruption of radiotherapy for toxicity.

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Adjuvant radiotherapy on older and oldest breast cancer patients after conservative surgery: A retrospective analysis

Cited by 9 publications

References 21 publications

The Treatment of Primary Breast Cancer in Older Women With Adjuvant Therapy

The Treatment of Primary Breast Cancer in Older Women With Adjuvant Therapy

Prognostic factors in elderly patients with breast cancer

Quality assurance in radiotherapy: analysis of the causes of not starting or early radiotherapy withdrawal

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