Hormonoradiotherapie adjuvante concomitante des cancers du sein: etat de l'art. [Adjuvant treatment of breast cancer by concomitant hormonotherapy and radiotherapy: state of the art]

Details

Serval ID
serval:BIB_81E4BA634F5F
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Hormonoradiotherapie adjuvante concomitante des cancers du sein: etat de l'art. [Adjuvant treatment of breast cancer by concomitant hormonotherapy and radiotherapy: state of the art]
Journal
Cancer RadioThérapie
Author(s)
Azria  D., Lemanski  C., Zouhair  A., Gutowski  M., Belkacemi  Y., Dubois  J. B., Romieu  G., Ozsahin  M.
ISSN
1278-3218 (Print)
Publication state
Published
Issued date
06/2004
Volume
8
Number
3
Pages
188-96
Notes
English Abstract
Journal Article
Review --- Old month value: Jun
Abstract
Combining radiation and hormone therapy has become common clinical practice in recent years for locally advanced prostate cancer. The use of such concomitant therapy in the treatment of breast disease has been very infrequently reported in the literature, but such an application seems justified given the common hormonal dependence of breast cancer and the potential synergetic effect of these two treatment modalities. As adjuvant therapy, tamoxifen is the key drug in the hormonal treatment arsenal, providing a significant improvement in both local control and global survival rates. Aromatase inhibitors are currently being evaluated in this setting, and initial results are promising. In vitro, tamoxifen does not seem to offer a protective effect against radiation. In clinical use, the few available published studies confirm the superiority of the association of radiation with tamoxifen as opposed to radiation therapy alone in decreasing local recurrences of surgically removed breast tumors. Toxicity associated with such concomitant therapy includes mainly subcutaneous and pulmonary fibroses. However, subcutaneous fibrosis and its cosmetic impact on the treated breast are frequently described side effects of radiation therapy, and their incidence may actually be reduced when tamoxifen is associated. The evidence is less controversial for pulmonary fibrosis, which is more common with the concomitant therapy. The association of radiation and aromatase inhibitors has as of yet rarely been reported. Letrozole (Femara) has a radiosensitizing effect on breast-cancer cell lines transfected with the aromatase gene. Clinical data assessing this effect in vivo are not available. The FEMTABIG study (letrozole vs. tamoxifen vs. sequential treatment) did not specify the sequence of radiation and hormonal therapy. The ATAC study comparing the adjuvant use of anastrozole (Arimidex) and tamoxifen does not provide any information on the number of patients receiving radiation concomitant with the hormonal treatment, and in addition also does not specify the sequence of radiation and hormonal treatment. The TEAM study compared exemestane (Aromasine) and tamoxifen, but specified that hormonal treatment follow the completion of radiation therapy.
Keywords
Adult Antineoplastic Agents, Hormonal/*therapeutic use Aromatase Inhibitors Breast Neoplasms/*drug therapy/*radiotherapy/surgery Chemotherapy, Adjuvant Clinical Trials Combined Modality Therapy Female Humans Prognosis Radiotherapy, Adjuvant Tamoxifen/therapeutic use
Pubmed
Create date
24/01/2008 18:20
Last modification date
20/08/2019 15:42
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