TY - JOUR
T1 - Effect of local therapy on locoregional recurrence in postmenopausal women with breast cancer in the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial
AU - Van Hezewijk, Marjan
AU - Bastiaannet, Esther
AU - Putter, Hein
AU - Scholten, Astrid N.
AU - Liefers, Gerrit Jan
AU - Rea, Daniel
AU - Hasenburg, Annette
AU - Paridaens, Robert
AU - Hozumi, Yasuo
AU - Markopoulos, Christos
AU - Seynaeve, Caroline
AU - Jones, Stephen E.
AU - Marijnen, Corrie A.M.
AU - Van De Velde, Cornelis J.H.
PY - 2013/8/1
Y1 - 2013/8/1
N2 - Background and purpose The TEAM trial investigated the efficacy and safety of adjuvant endocrine therapy consisting of either exemestane or the sequence of tamoxifen followed by exemestane in postmenopausal hormone-sensitive breast cancer. The present analyses explored the association between locoregional therapy and recurrence (LRR) in this population. Material and methods Between 2001 and 2006, 9779 patients were randomized. Local treatment was breast conserving surgery plus radiotherapy (BCS + RT), mastectomy without radiotherapy (MST-only), or mastectomy plus radiotherapy (MST + RT). Patients with unknown data on surgery, radiotherapy, tumor or nodal stage (n = 199), and patients treated by lumpectomy without radiotherapy (n = 349) were excluded. Results After a median follow-up of 5.2 years, 270 LRRs occurred (2.9%) among 9231 patients. The 5-years actuarial incidence of LRR was 4.2% (95% CI 3.3-4.9%) for MST-only, 3.4% (95% CI 2.4-4.2%) for MST + RT and 1.9% (95% CI 1.5-2.3%) for BCS + RT. After adjustment for prognostic factors, the hazard ratio (HR, reference BCS + RT) for LRR remained significantly higher for MST-only (HR 1.53; 95% CI 1.10-2.11), not for MST + RT (HR 0.78; 95% CI 0.50-1.22). Conclusion This explorative analysis showed a higher LRR risk after MST-only than after BCS + RT, even after adjustment for prognostic factors. As this effect was not seen for MST + RT versus BCS + RT, it might be explained by the beneficial effects of radiation treatment.
AB - Background and purpose The TEAM trial investigated the efficacy and safety of adjuvant endocrine therapy consisting of either exemestane or the sequence of tamoxifen followed by exemestane in postmenopausal hormone-sensitive breast cancer. The present analyses explored the association between locoregional therapy and recurrence (LRR) in this population. Material and methods Between 2001 and 2006, 9779 patients were randomized. Local treatment was breast conserving surgery plus radiotherapy (BCS + RT), mastectomy without radiotherapy (MST-only), or mastectomy plus radiotherapy (MST + RT). Patients with unknown data on surgery, radiotherapy, tumor or nodal stage (n = 199), and patients treated by lumpectomy without radiotherapy (n = 349) were excluded. Results After a median follow-up of 5.2 years, 270 LRRs occurred (2.9%) among 9231 patients. The 5-years actuarial incidence of LRR was 4.2% (95% CI 3.3-4.9%) for MST-only, 3.4% (95% CI 2.4-4.2%) for MST + RT and 1.9% (95% CI 1.5-2.3%) for BCS + RT. After adjustment for prognostic factors, the hazard ratio (HR, reference BCS + RT) for LRR remained significantly higher for MST-only (HR 1.53; 95% CI 1.10-2.11), not for MST + RT (HR 0.78; 95% CI 0.50-1.22). Conclusion This explorative analysis showed a higher LRR risk after MST-only than after BCS + RT, even after adjustment for prognostic factors. As this effect was not seen for MST + RT versus BCS + RT, it might be explained by the beneficial effects of radiation treatment.
KW - Breast cancer
KW - Breast conserving surgery
KW - Locoregional recurrence
KW - Mastectomy
KW - Postmenopausal women
KW - Radiation
UR - http://www.scopus.com/inward/record.url?scp=84885384008&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2013.08.020
DO - 10.1016/j.radonc.2013.08.020
M3 - Article
C2 - 24044798
AN - SCOPUS:84885384008
SN - 0167-8140
VL - 108
SP - 190
EP - 196
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -