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Concurrent trastuzumab with adjuvant radiotherapy in HER2-positive breast cancer patients: acute toxicity analyses from the French multicentric study

Belkacémi, Y. ; Gligorov, J. ; Ozsahin, M. ; Marsiglia, H. ; De Lafontan, B. ; Laharie-Mineur, H. ; Aimard, L. ; Antoine, E.-C ; Cutuli, B. ; Namer, M. ; Azria, D.

In: Annals of Oncology, 2008, vol. 19, no. 6, p. 1110-1116

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    Titre
    • Concurrent trastuzumab with adjuvant radiotherapy in HER2-positive breast cancer patients: acute toxicity analyses from the French multicentric study
    Auteur
    • Belkacémi, Y.. Department of Radiation Oncology, CLCC Oscar Lambret Anti-Cancer Center
    • Gligorov, J.. Department of Medical Oncology APHP Tenon, Cancer Est, Paris, France
    • Ozsahin, M.. Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois
    • Marsiglia, H.. Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
    • De Lafontan, B.. Department of Radiation Oncology, Institut Claudius Regaud, Toulouse
    • Laharie-Mineur, H.. Department of Radiation Oncology, Institut Bergonié, Bordeaux
    • Aimard, L.. Clairval Clinic, Marseille
    • Antoine, E.-C. Hartmann Clinic, Neuilly sur Seine
    • Cutuli, B.. Courlancy Polyclinic, Reims
    • Namer, M.. Department of Medical Oncology, Centre Azuréen de Cancérologie, Mougins
    • Azria, D.. Department of Radiation Oncology, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • Annals of Oncology, 2008, vol. 19, no. 6, p. 1110-1116. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:298278
    Summary
    Background: Trastuzumab (T) combined with chemotherapy has been recently shown to improve outcome in HER2-positive breast cancer (BC). The aim of this study was to evaluate the toxic effects of concurrent radiation therapy (RT) and T administration in the adjuvant setting. Patients and methods: Data of 146 patients with stages II-III HER2-positive BC were recorded. Median age was 46 years. In all, 32 (23%) and 114 (77%) patients received a weekly and a 3-week T schedule, respectively. A median dose of 50 Gy was delivered after surgery. Internal mammary chain (IMC) was irradiated in 103 (71%) patients. Results: Grade >2 dermatitis and esophagitis were noted in 51% and 12%, respectively. According to the Common Toxicity Criteria v3.0 scale and HERA (HERceptin Adjuvant) trial criteria, respectively, 10% and 6% of the patients had a grade ≥2 of left ventricular ejection fraction (LVEF) decrease after RT. Multivariate analyses revealed two independent prognostic factors: weekly T administration (for LVEF decrease) and menopausal status (for dermatitis). Higher level of T cumulative dose (>1600 mg) was only borderline of statistical significance for acute esophagitis toxicity. Conclusion: We showed that weekly concurrent T and RT are feasible in daily clinical practice with, however, a decrease of LVEF. Cardiac volume sparing and patient selections for IMC irradiation are highly recommended. Longer follow-up is warranted to evaluate late toxic effects