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Title: 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

Abstract

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 formore » 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.« less

Authors:
 [1];  [2];  [2];  [3];  [4];  [5];  [6];  [7];  [7];  [8];  [5];  [5]
  1. Department of Radiation Oncology, Hopital Tenon, AP-HP, Paris (France). E-mail: alain.toledano@gmail.com
  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, Hopital Tenon, AP-HP, Paris (France)
  5. Department of Radiation Oncology, Henry Kaplan CHU Bretonneau, Tours (France)
  6. Department of Radiation Oncology, Institut Sainte-Catherine, Avignon (France)
  7. Department of Radiation Oncology, CHU Minjoz, Besancon (France)
  8. Department of Radiation Oncology, CHR La Source, Orleans (France)
Publication Date:
OSTI Identifier:
20951616
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 68; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2006.12.006; PII: S0360-3016(06)03638-8; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; COMBINED THERAPY; MAMMARY GLANDS; PATIENTS; RADIOTHERAPY; SURGERY

Citation Formats

Toledano, Alain H., Bollet, Marc A., Fourquet, Alain, Azria, David, Gligorov, Joseph, Garaud, Pascal, Serin, Daniel, Bosset, Jean-Francois, Miny-Buffet, Joelle, Favre, Anne, Le Foch, Olivier, and Calais, Gilles. 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. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.12.006.
Toledano, Alain H., Bollet, Marc A., Fourquet, Alain, Azria, David, Gligorov, Joseph, Garaud, Pascal, Serin, Daniel, Bosset, Jean-Francois, Miny-Buffet, Joelle, Favre, Anne, Le Foch, Olivier, & Calais, Gilles. 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. United States. doi:10.1016/j.ijrobp.2006.12.006.
Toledano, Alain H., Bollet, Marc A., Fourquet, Alain, Azria, David, Gligorov, Joseph, Garaud, Pascal, Serin, Daniel, Bosset, Jean-Francois, Miny-Buffet, Joelle, Favre, Anne, Le Foch, Olivier, and Calais, Gilles. Tue . "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". United States. doi:10.1016/j.ijrobp.2006.12.006.
@article{osti_20951616,
title = {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},
author = {Toledano, Alain H. and Bollet, Marc A. and Fourquet, Alain and Azria, David and Gligorov, Joseph and Garaud, Pascal and Serin, Daniel and Bosset, Jean-Francois and Miny-Buffet, Joelle and Favre, Anne and Le Foch, Olivier and Calais, Gilles},
abstractNote = {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.},
doi = {10.1016/j.ijrobp.2006.12.006},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 68,
place = {United States},
year = {Tue May 01 00:00:00 EDT 2007},
month = {Tue May 01 00:00:00 EDT 2007}
}