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A Randomized Trial Comparing Concurrent versus Sequential Radiation and Endocrine Therapy in Early-Stage, Hormone-Responsive Breast Cancer

Authors :
Sharon F. McGee
Mark Clemons
Gregory Pond
Jean-Michel Caudrelier
Michelle Liu
Mashari Jemaan Alzahrani
Terry L. Ng
Arif A. Awan
Sandeep Sehdev
John Hilton
Marie-France Savard
Lesley Fallowfield
Vikaash Kumar
Orit Freedman
Lisa Vandermeer
Brian Hutton
Jean-Marc Bourque
Source :
Current Oncology, Vol 31, Iss 8, Pp 4531-4545 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Concerns exist regarding increased toxicities, including endocrine therapy toxicity, with concurrent radiation and endocrine therapy in early breast cancer (EBC). We present a pragmatic, randomized trial comparing concurrent versus sequential endocrine and radiotherapy in hormone-responsive EBC. In this multicenter trial, patients were randomized to receive adjuvant endocrine therapy concurrent with, or sequential to, radiotherapy. The primary outcome was change in endocrine therapy toxicity from baseline to 3 months post radiotherapy using the Functional Assessment of Cancer Therapy–Endocrine Symptom (FACT-ES) score. From September 2019 to January 2021, 133 patients were randomized to concurrent endocrine and radiotherapy, and 127 to sequential treatment. Most patients were post-menopausal (72.7%, 189/260) with stage 1 disease (65.8%, 171/260). Tamoxifen was the endocrine therapy of choice for 69.6% (181/260) of patients, and an aromatase inhibitor for the remainder. The median total radiation dose and fractions were 40.1 Gray (range 26–50) and 15 fractions (range 5–25), respectively. For the primary outcome of change in endocrine therapy toxicity per FACT-ES scores from baseline to 3 months post radiotherapy, no significant difference was found between the groups (median [range] = −4.9 (−82, 38.8) for concurrent and −5.1 (−42, 40) for sequential, p = 0.87). This is the first trial to investigate the impact of concurrent versus sequential adjuvant endocrine and radiotherapy on endocrine therapy-related toxicities. The findings provide further support to allow the optimal timing of radiation and endocrine therapy to be tailored for the individual patient.

Details

Language :
English
ISSN :
17187729 and 11980052
Volume :
31
Issue :
8
Database :
Directory of Open Access Journals
Journal :
Current Oncology
Publication Type :
Academic Journal
Accession number :
edsdoj.2fd4e23646ed407ea822b33ad3dcffab
Document Type :
article
Full Text :
https://doi.org/10.3390/curroncol31080338