Breast Cancer Radiotherapy Outcomes and Affecting Factors

Year 2019, , 78 - 86, 01.05.2019

Suheyla Aytaç Arslan

https://doi.org/10.5505/abantmedj.2019.93899

Abstract

INTRODUCTION: The aim of this study was to evaluate the effect of different stage, clinical status and RT techniques on the treatment outcome and to compare these results with the literature.METHODS: In our center, 121 breast cancer patients which treated with curative radiotherapy between April 2012-June 2016 were evaluated retrospectively. Patient demographics, tumor localization, stage, chemotherapy protocols, dose-volume histograms, acute and chronic side effects, treatment response and final status were determined; acute side effect, disease free survival DFS and overall survival OS were evaluated. RESULTS: The clinical and pathological stage was the most important determinant for OS and DFS. More aggressive axillary dissection was seen in high-disease patients. In multivariate analyzes, a lower OS was observed in the aggressive axillary dissection arm independently of the clinical setting. No local recurrence was observed in any of our patients and distant metastasis was observed in six patients at median follow up of 37 months. Increased tumor size was found to be associated with surgical margin SM positivity. Patients with SM negative had a median pathologic tumor size of 3 cm, whereas SM positive pathologic tumor size was 8 cm. When the treatment techniques were evaluated, it was seen that the intensity modulated radiotherapy technique was chosen for patient with left breast tumors or bilateral tumors. In terms of oncologic outcome and acute side effects, the choice of technique was not significant. DISCUSSION AND CONCLUSION: The disease stege and age in breast cancer are important prognostic factors in terms of OS and DFS and the results of the study are consistent with the literature.

Keywords

Breast cancer, radiodermitis, radiotherapy, toxicity, intensity modulated radiotherapy

Meme Kanseri Hastalarında Radyoterapi Sonuçlarımız Ve Etki Eden Faktörler

Abstract

GİRİŞ ve AMAÇ: Bu çalışmada kliniğimizde başvuran hastalarda, farklı evre, klinik durum ve RT tekniklerinin tedavi sonuçları üzerindeki etkisi ve bu sonuçların literatür ile uyumunu değerlendirmek amaçlanmıştır.YÖNTEM ve GEREÇLER: Ankara Atatürk Eğitim Araştırma Hastanesinde Nisan 2012- Haziran 2016 tarihleri arasında meme kanseri tanısı ile küratif radyoterapi almış 121 hasta retrospektif olarak değerlendirilmiştir. Hastaların demografik durumları, tümör lokalizasyonu, evresi, kemoterapi protokolleri, doz- volüm histogramları, akut ve kronik yan etkileri, tedavi yanıtı ve son durumu tespit edilmiş; akut yan etki, hastalıksız sağkalım HSK ve genel sağkalım GSK sonuçları değerlendirilmiştir.BULGULAR: Hastalık evresi arttıkça anlamlı olarak GSK ve HSK kötüleşmiştir. GSK hasta yaşı düştükçe ≤40 , cT, pT evresi ilerlerdikçe düşme eğilimi göstermiştir. Klinik evresi yüksek hastalarda daha agresif aksiller diseksiyon yapıldığı görülmüştür. Çok değişkenli analizlerde ise klinik evreden bağımsız olarak agresif aksiller diseksiyon kolunda daha düşük GSK izlenmiştir. Çalışmamızın ortanca 37 aylık takip süresinde hiçbir hastamızda lokal nüks izlenmemiş, altı hastada uzak metastaz izlenmiştir. Tümör boyutu artışının CS pozitifliği ile ilişkili olduğu görülmüştür. CS negatif olan hastaların ortanca patolojik tümör boyutu 3 cm iken, CS pozitif kolda patolojik tümör boyutu 8 cm’dir. Tedavi tekniğinin değerlendirilmesinde sol lezyonlarda ve bilateral tümörlerde YART tercih edildiği izlenmiştir. Onkolojik sonuç ve akut yan etki açısından radyoterapi tekniğinin anlamlı bir etkisi olmamıştır. Hiçbir hastamızda grad 3 yan etki izlenmemiş olup en sık izlenen yan etki grad 1 radyodermittir.TARTIŞMA ve SONUÇ: Meme kanserinde hastalık evresi ve yaş GSK ve HSK açısından önemli prognostik faktörlerdir ve çalışma sonuçları literatür ile uyumludur.

Keywords

Meme Kanseri, Radyodermit, Radyoterapi, Toksisite, Yoğunluk Ayarlı Radyoterapi

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