Impact of delayed Radiotherapy on outcome of breast cancer patients after Breast-Conservative Surgery. A Retrospective Analysis; Mansoura Experience | ||||
| SECI Oncology Journal | ||||
| Article 1, Volume 11, Issue 3, July 2023, Page 162-171 | ||||
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| Abstract | ||||
| Background: Breast cancer is the second most prevalent type of cancer and the most common cancer among women. The gold standard in the treatment of breast cancer is postoperative radiation following breast-conserving surgery (BCS). The optimal timing to begin postoperative radiation therapy (RT) is still up for debate. Objective: The purpose of the study is to determine if the gap between BCS and postoperative RT has any impact on the frequency of local or distant relapses and overall survival in female patients with breast cancer. Patients and Methods: Following the scheduling of radiation, we split the 302 female patients into two groups: ≤180 days and >180 days, and retrospectively examined the clinical data. The Fisher exact test, the χ2test or dummy variables were used to determine if the two groups had an unbalanced distribution of prognostic and treatment variables. The Kaplan-Meier survival analysis and a restricted mean survival time (RMST) were used to assess local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OAS). After correcting for known confounding variables, multivariate Cox regression was performed to test for the independent effect of time of RT. The typical median time of follow-up was 6.5 years. Results: There were statistically significant differences in the distribution of pathological stage, chemotherapy regimens, timing of the initiation of chemotherapy (neoadjuvant or adjuvant), and total dose of radiation. We were unable to find a relation between the time interval and the probability of local relapse at the 6.5-year median time of follow-up (p = 0.285 and 0.259) in both the univariate and multivariate analyses. When radiation was begun later than recommended, the DMFS and OAS univariate analyses revealed no influence on outcome (p = 0.3445 and p = 0.249, respectively), and the multivariate analysis supported this finding (p = 0.578 and p = 0.487, respectively). Conclusion: Our findings demonstrate that there is no relationship between the scheduling of postoperative RT and the chance of local relapse, distant metastasis, or progression of overall survival in our groups. | ||||
| Keywords | ||||
| Timing; Radiotherapy; breast cancer; breast conservative surgery Local relapse; Distant metastases; Survival | ||||
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