BREAST RADIOTHERAPY FOR METASTATIC DISEASE

Radiotherapy Helpful When Breast Cancer Is Advanced at Diagnosis

NEW YORK (Reuters Health) Feb 17 - Locoregional radiotherapy (LRR) is an effective approach in breast cancer patients with synchronous metastases at the time of diagnosis, according to French researchers.

"Our results," lead investigator Dr. Romuald Le Scodan told Reuters Health, "confirm the survival advantage conferred by surgery or radiation therapy of the primary tumor in breast cancer patients with synchronous metastases."

"Exclusive LRR may be an effective alternative to surgery," he continued, "with the added advantage of being a conservative treatment."

In the February 9th on-line issue of the Journal of Clinical Oncology, Dr. Le Scodan and colleagues at Centre Rene Huguenin in Saint Cloud report on 581 patients with synchronous metastases at diagnosis of their breast cancer. Locoregional therapy was employed in 320 patients (exclusive LRR in 249, resection of the primary tumor plus adjuvant LRR in 41, and surgery alone in 30). In the remaining 261 patients, no locoregional therapy was used.

"Locoregional therapy, consisting mainly of exclusive LRR, was associated with improved survival," the authors found. In patients who received any locoregional treatment, the median survival was 32 months and the 3-year overall survival rate was 43.4%. In those with no locoregional treatment, median survival was 21 months and the 3-year overall survival rate was 26.7% (p=0.00002).

"Our results," added Dr. Le Scodan, "suggest that patients with extensive metastatic disease at diagnosis also benefit from LRR of the primary tumor."

"Well designed prospective studies, including LRR as the only locoregional treatment, are needed to re-evaluate treatment of the primary breast tumor in patients with metastases at diagnosis, and to identify those patients who are most likely to benefit," he concluded.