Does Concurrent Radiochemotherapy Affect Cosmetic Results in the Adjuvant Setting After Breast-Conserving Surgery? Results of the ARCOSEIN Multicenter, Phase III Study: Patients' and Doctors' Views

Journal Article · Tue May 01 04:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.12.006· OSTI ID:20951616

Toledano, Alain H ^[1]; Bollet, Marc A ^[2]; Fourquet, Alain ^[2]; Azria, David ^[3]; Gligorov, Joseph ^[1]; Garaud, Pascal ^[4]; Serin, Daniel ^[5]; Bosset, Jean-Francois ^[6]; Miny-Buffet, Joelle ^[6]; Favre, Anne ^[7]; Le Foch, Olivier ^[4]; Calais, Gilles ^[4]

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1. Department of Radiation Oncology, Hopital Tenon, AP-HP, Paris (France)
2. Department of Radiation Oncology, Institut Curie, Paris (France)
3. Department of Radiation Oncology, CRLC Val d'Aurelle, Montpellier (France)
4. Department of Radiation Oncology, Henry Kaplan CHU Bretonneau, Tours (France)
5. Department of Radiation Oncology, Institut Sainte-Catherine, Avignon (France)
6. Department of Radiation Oncology, CHU Minjoz, Besancon (France)
7. Department of Radiation Oncology, CHR La Source, Orleans (France)

Purpose: To evaluate the cosmetic results of sequential vs. concurrent adjuvant chemotherapy with radiotherapy after breast-conserving surgery for breast cancer, and to compare ratings by patients and physicians. Methods and Materials: From 1996 to 2000, 716 patients with Stage I-II breast cancers were included in a multicenter, Phase III trial (the ARCOSEIN study) comparing, after breast-conserving surgery with axillary dissection, sequential treatment with chemotherapy first followed by radiotherapy vs. chemotherapy administered concurrently with radiotherapy. Cosmetic results with regard to both the overall aspect of the breast and specific changes (color, scar) were evaluated in a total of 214 patients (107 in each arm) by means of questionnaires to both the patient and a physician whose rating was blinded to treatment allocation. Results: Patients' overall satisfaction with cosmesis was not statistically different between the two arms, with approximately 92% with at least satisfactory results (p = 0.72), although differences between the treated and untreated breasts were greater after the concurrent regimen (29% vs. 14% with more than moderate differences; p 0.0015). Physician assessment of overall cosmesis was less favorable, with lower rates of at least satisfactory results in the concurrent arm (60% vs. 85%; p = 0.001). Consequently, the concordance for overall satisfaction with cosmesis between patients and doctors was only fair ({kappa} = 0.62). Conclusion: After breast-conserving surgery, the concurrent use of chemotherapy with radiotherapy is significantly associated with greater differences between the breasts. These differences do not translate into patients' lessened satisfaction with cosmesis.

• OSTI ID: 20951616
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 68; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
COMBINED THERAPY
MAMMARY GLANDS
PATIENTS
RADIOTHERAPY
SURGERY