Radiation therapy benefited some elderly breast cancer patients
Radiation therapy benefited some elderly breast cancer patients25 Sep 2015
Adjuvant radiation therapy after lumpectomy for elderly women with early stage triple negative breast cancer improved overall survival and disease specific survival, a retrospective analysis of cases from the Surveillance, Epidemiology, and End Result (SEER) database has shown.
The review showed that adjuvant radiation was associated with an overall six-fold decrease in any death, as well as death from breast cancer, Sean Szeja, MD, of The University of Texas Medical Branch at Galveston, and colleagues reported.
Breast cancer-related decreased survival rates were more common in the lumpectomy
From 2010-2011, SEER contained 109,559 cases of breast cancer with recorded results of Her-2-neu (H2N) status. Combining other receptor values, showed 12,620 triple-negative cases (12%). Of these, 6,980 (55%) had stage T1-2, N0, M0, said the investigators. Lumpectomy was performed in 4,002 of these cases.
The investigators identified 974 women ages 70 and older with stage T1-2, NO, MO triple negative breast cancer who underwent lumpectomy. Of this group, 662 (68%) received adjuvant radiation therapy.
The analysis showed that after 23 months:
- Lumpectomy plus radiation therapy was associated with improved overall survival at 98.2% compared with 85.6% for lumpectomy only, as well as
- Disease specific survival at 99% for lumpectomy plus radiation therapy better than 94% for lumpectomy only.
- Radiation demonstrated improved overall survival and disease specific survival.
"Prior to this study, there has not been any measurement of the reduction of breast cancer specific mortality from the addition of radiation to lumpectomy in this patient population," noted Szeja. "There is limited information on outcomes in this group of women with triple negative breast cancers treated with breast conserving surgery with and without radiation," Kilian Salerno, MD, commented.
Compelling results leading to further investigation
Although the study controlled for many important prognostic factors such as stage and age, it was not able to control for the patient's comorbidities and overall state of health, he acknowledged. "It is probable that more intensive treatment plans including radiation and chemotherapy were recommended for the healthier patients, and therefore some of the observed survival benefit derived from this bias," Szeja commented.
Even with the limitations of the study, the results are still compelling enough to warrant further investigation, possibly with a clinical trial, agreed Jessica Young, MD, assistant professor of oncology, breast surgery division, department of surgical oncology at Roswell Park Cancer institute.
"This study suggests that adjuvant radiation therapy may benefit some elderly patients with breast cancer, but a prospective study will be needed to guide treatment decisions," commented Harold J. Burstein, MD, PhD, FASCO, of Dana-Farber Cancer Institute in Boston, MA.Source: MedPage Today