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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’

2008; Elsevier BV; Volume: 44; Issue: 17 Linguagem: Inglês

10.1016/j.ejca.2008.07.032

1879-0852

Sandra Collette, Laurence Collette, Tom Budiharto, Jean-Claude Horiot, Philip Poortmans, H. Struikmans, Walter Van den Bogaert, Alain Fourquet, J.J. Jager, W.J. Hoogenraad, Rolf‐Peter Mueller, John M. Kurtz, D.A.L. Morgan, Jean‐Bernard Dubois, E. Salamon, R.O. Mirimanoff, M. Bolla, Marleen van der Hulst, Carla C. Wárlám-Rodenhuis, Harry Bartelink,

Breast Implant and Reconstruction

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 chemotherapy, 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 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.