1. 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'
- Author
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UCL, Collette, Sandra, Collette, Laurence, Budiharto, Tom, Horiot, Jean-Claude, Poortmans, Philip M., Struikmans, Henk, Van den Bogaer, Walter, Fourquet, Alain, Jagerg, Jos J., Hoogenraad, Willem, Mueller, Rolf-Peter, Kurtz, John, Morgan, David A. L., Dubois, Jean-Bernard, Salamon, Emile, Mirimanoff, Rene, Bolla, Michel, Van der Hulst, Marleen, Warlam-Rodenhuis, Carla C., Bartelink, Harry, UCL, Collette, Sandra, Collette, Laurence, Budiharto, Tom, Horiot, Jean-Claude, Poortmans, Philip M., Struikmans, Henk, Van den Bogaer, Walter, Fourquet, Alain, Jagerg, Jos J., Hoogenraad, Willem, Mueller, Rolf-Peter, Kurtz, John, Morgan, David A. L., Dubois, Jean-Bernard, Salamon, Emile, Mirimanoff, Rene, Bolla, Michel, Van der Hulst, Marleen, Warlam-Rodenhuis, Carla C., and Bartelink, Harry
- 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.
- Published
- 2008