Exclusive intraoperative radiotherapy for invasive breast cancer in elderly patients (>70 years): proportion of eligible patients and local recurrence-free survival

Eric Lambaudie, Gilles Houvenaeghel, Amira Ziouèche, Sophie Knight, François Dravet, Jean Remy Garbay, Sylvie Giard, Hélène Charitansky, Monique Cohen, Christelle Faure, Delphine Hudry, Paul Azuar, Richard Villet, Pierre Gimbergues, Christine Tunon de Lara, Agnès Tallet, Marie Bannier, Mathieu Minsat, Michel Resbeut, Eric Lambaudie, Gilles Houvenaeghel, Amira Ziouèche, Sophie Knight, François Dravet, Jean Remy Garbay, Sylvie Giard, Hélène Charitansky, Monique Cohen, Christelle Faure, Delphine Hudry, Paul Azuar, Richard Villet, Pierre Gimbergues, Christine Tunon de Lara, Agnès Tallet, Marie Bannier, Mathieu Minsat, Michel Resbeut

Abstract

Background: To estimate the proportion of elderly patients (>70 years) with breast cancer eligible for an Exclusive IntraOperative RadioTherapy (E-IORT) and to evaluate their local recurrence-free survival rate.

Methods: This retrospective study examining two cohorts focuses on patients over 70 years old: a multi-centric cohort of 1411 elderly patients and a mono-centric cohort of 592 elderly patients. All patients underwent conservative surgery followed by external radiotherapy for T0-T3 N0-N1 invasive breast cancer, between 1980 and 2008.

Results: Within each cohort two groups were identified according to the inclusion criteria of the RIOP trial (R group) and TARGIT E study (T group). Each group was divided into two sub-groups, patients eligible (E) or non-eligible (nE) for IORT. The population of patients that were eligible in the TARGIT E study but not in the RIOP trial were also studied in both cohorts. The proportion of patients eligible for IORT was calculated, according to the eligibility criteria of each study. A comparison of the 5-year local or locoregional recurrence-free survival rate between eligible vs non-eligible patients was made. In both cohorts, the proportion of patients eligible according to the RIOP trial's eligibility criteria was 35.4 and 19.3%, and according to the TARGIT E study criteria was 60.9 and 45.3%. The 5-year locoregional recurrence-free survival rate was not significantly different between RE and RnE groups, TE and TnE groups. In both cohorts RE and (TE-RE) groups were not significantly different.

Conclusions: Our results encourage further necessary studies to define and to extend the eligibility criteria for per operative exclusive radiotherapy.

Keywords: Breast cancer; Elderly patients; Intraoperative radiotherapy.

Figures

Fig. 1
Fig. 1
Flowchart figure. Keys: R = RIOP, T = Targit E, E = eligible, nE = not eligible

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Source: PubMed

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