Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis
PurposeTo investigate the effect of chemotherapy and radiotherapy timing after breast conserving surgery (BCS) on recurrence and survival of women with early-stage breast cancer.Patients and MethodsWe retrospectively analyzed 900 patients who underwent BCS followed by both adjuvant chemotherapy and...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.571390/full |
| _version_ | 1818538494729912320 |
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| author | Si-Ye Chen Yu Tang Shu-Lian Wang Yong-Wen Song Hui Fang Jian-Yang Wang Hao Jing Jiang-Hu Zhang Guang-Yi Sun Xu-Ran Zhao Jing Jin Yue-Ping Liu Bo Chen Shu-Nan Qi Ning Li Yuan Tang Ning-Ning Lu Hua Ren Zi-Hao Yu Ye-Xiong Li |
| author_facet | Si-Ye Chen Yu Tang Shu-Lian Wang Yong-Wen Song Hui Fang Jian-Yang Wang Hao Jing Jiang-Hu Zhang Guang-Yi Sun Xu-Ran Zhao Jing Jin Yue-Ping Liu Bo Chen Shu-Nan Qi Ning Li Yuan Tang Ning-Ning Lu Hua Ren Zi-Hao Yu Ye-Xiong Li |
| author_sort | Si-Ye Chen |
| collection | DOAJ |
| description | PurposeTo investigate the effect of chemotherapy and radiotherapy timing after breast conserving surgery (BCS) on recurrence and survival of women with early-stage breast cancer.Patients and MethodsWe retrospectively analyzed 900 patients who underwent BCS followed by both adjuvant chemotherapy and radiotherapy. Of these, 488 women received chemotherapy first (CT-first group) while the other 412 received radiotherapy first (RT-first group). Locoregional recurrence (LRR), distant metastasis (DM), disease-free survival (DFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method and further confirmed with propensity-score matching (PSM) and the Cox proportional hazards model. The optimal cut-off value of interval time from surgery to the start of chemotherapy was calculated by Maxstat.ResultsThe median follow-up was 7.1 years. In pre-match analysis, the CT-first group had a significantly higher 8-year DFS than the RT-first group (90.4% vs. 83.1%, P = 0.005). PSM analysis of 528 patients indicated that the 8-year DFS (91.0% vs. 83.3%, P = 0.005) and DM (8.6% vs. 14.6%, P = 0.017) were significantly better in the CT-first group, but that the OS (P = 0.096) and LRR (P = 0.434) were similar. We found the optimal cut-off value of interval from surgery to chemotherapy was 12 weeks. Patients starting chemotherapy later than 12 weeks after surgery had significantly inferior survival outcomes.ConclusionFor women with breast cancer who require both chemotherapy and radiotherapy after BCS, adjuvant chemotherapy should be started within 12 weeks. Delaying the initiation of radiotherapy, for administration of long-course chemotherapy, does not compromise outcomes. |
| first_indexed | 2024-12-11T21:29:41Z |
| format | Article |
| id | doaj.art-ac9447c64b85479aafc09409605de3ae |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-11T21:29:41Z |
| publishDate | 2020-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-ac9447c64b85479aafc09409605de3ae2022-12-22T00:50:12ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-09-011010.3389/fonc.2020.571390571390Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective AnalysisSi-Ye ChenYu TangShu-Lian WangYong-Wen SongHui FangJian-Yang WangHao JingJiang-Hu ZhangGuang-Yi SunXu-Ran ZhaoJing JinYue-Ping LiuBo ChenShu-Nan QiNing LiYuan TangNing-Ning LuHua RenZi-Hao YuYe-Xiong LiPurposeTo investigate the effect of chemotherapy and radiotherapy timing after breast conserving surgery (BCS) on recurrence and survival of women with early-stage breast cancer.Patients and MethodsWe retrospectively analyzed 900 patients who underwent BCS followed by both adjuvant chemotherapy and radiotherapy. Of these, 488 women received chemotherapy first (CT-first group) while the other 412 received radiotherapy first (RT-first group). Locoregional recurrence (LRR), distant metastasis (DM), disease-free survival (DFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method and further confirmed with propensity-score matching (PSM) and the Cox proportional hazards model. The optimal cut-off value of interval time from surgery to the start of chemotherapy was calculated by Maxstat.ResultsThe median follow-up was 7.1 years. In pre-match analysis, the CT-first group had a significantly higher 8-year DFS than the RT-first group (90.4% vs. 83.1%, P = 0.005). PSM analysis of 528 patients indicated that the 8-year DFS (91.0% vs. 83.3%, P = 0.005) and DM (8.6% vs. 14.6%, P = 0.017) were significantly better in the CT-first group, but that the OS (P = 0.096) and LRR (P = 0.434) were similar. We found the optimal cut-off value of interval from surgery to chemotherapy was 12 weeks. Patients starting chemotherapy later than 12 weeks after surgery had significantly inferior survival outcomes.ConclusionFor women with breast cancer who require both chemotherapy and radiotherapy after BCS, adjuvant chemotherapy should be started within 12 weeks. Delaying the initiation of radiotherapy, for administration of long-course chemotherapy, does not compromise outcomes.https://www.frontiersin.org/article/10.3389/fonc.2020.571390/fullbreast neoplasmbreast-conserving surgerychemotherapyradiotherapytiming |
| spellingShingle | Si-Ye Chen Yu Tang Shu-Lian Wang Yong-Wen Song Hui Fang Jian-Yang Wang Hao Jing Jiang-Hu Zhang Guang-Yi Sun Xu-Ran Zhao Jing Jin Yue-Ping Liu Bo Chen Shu-Nan Qi Ning Li Yuan Tang Ning-Ning Lu Hua Ren Zi-Hao Yu Ye-Xiong Li Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis Frontiers in Oncology breast neoplasm breast-conserving surgery chemotherapy radiotherapy timing |
| title | Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis |
| title_full | Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis |
| title_fullStr | Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis |
| title_full_unstemmed | Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis |
| title_short | Timing of Chemotherapy and Radiotherapy Following Breast-Conserving Surgery for Early-Stage Breast Cancer: A Retrospective Analysis |
| title_sort | timing of chemotherapy and radiotherapy following breast conserving surgery for early stage breast cancer a retrospective analysis |
| topic | breast neoplasm breast-conserving surgery chemotherapy radiotherapy timing |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.571390/full |
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