4. Sequence of radiotherapy (RT) wiih tamoxifen (TAM) in conservatively managed breast cancer (LRT)

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Abstract

Purpose: Laboratory data suggests that TAM may be less effective given concurrently with chemotherapy or RT due to decreased chemo/ radio-sensitivity. There is limited clinical data evaluating the timing of TAM with LRT and its impact on local relapse rates. This study was undertaken to evaluate whether the sequencing of TAM with LRT effects outcome. Methods: Between 1976 and 1999, 1856 patients were treated with LRT at YNHH. The timing of chemotherapy and TAM, relative to LRT were documented and recorded. Of the 529 patients who received TAM, the timing of the drug was unclear in 54 patients, was given concurrently with RT in 257 (CON_TAM) and after completion of RT in 218 (DELJAM). Results: There were no differences between the CON_TAM and DEL_TAM group in T-stage, histolo Gy, ER/PR, nodal, or margin status. The CON_TAM group was significantly older than the DEL_TAM group (63 yrs vs 58>Ts). The CON_TAM group also received chemotherapy in addition to TAM less frequently than the DEL_TAM group (M% vs 36%). As of 9/2002 with a median followup of 10.0 years, for the 1856 patients, the use of TAM was associated with a significant impact on local relapse free rate (RFR) (89% vs 85% at 10 years, P = .01) and a trend in lowering contralateral RFR (93% vs 89% at 15 years, P = N.S.). There were no significant differences between the CON_TAM and DEL_TAM groups in survival (85% vs 80%), distant RFR (84% vs 78%), ipsilateral breast RFR (90% vs 88%), or contralateral breast RFR (95% vs 92%). Of specific note, the timing of TAM did not effect the local relapse rates in any subgroup of patients analyzed. Conclusion: Although the concurrent use of TAM with LRT may theoretically render cancer cells less responsive, this retrospective study suggests that in practical application, concurrent administration of TAM with LRT does not appear to compromise local control or other outcomes. These data can be helpful and reassuring regarding the timing of TAM with RT.

Original languageEnglish (US)
Pages (from-to)485-486
Number of pages2
JournalCancer Journal
Volume9
Issue number6
DOIs
StatePublished - 1996
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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