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Abstract: Postmastectomy radiotherapy (PMRT) improves survival by eliminating potential occult lesions in the chest wall and lymphatic drainage area. Meta-analysis has shown that PMRT reduces mortality and local recurrence of patients with node positive breast cancer (but there is no specific data about the effectiveness of PMRT in a subgroup of patients with a high number of positive axillary lymph nodes (PALN). The aim of the study was to analyse the impact of the number of PALN on local and distant metastasis occurrence, overall survival (OS) and distant metastases free survival (DMFS) in patients treated with PMRT. Patients and methods. We reviewed medical records of 129 consecutive breast cancer patients with PALN, treated at Institute of Oncology Ljubljana with PMRT between January 2003 and December 2004. We grouped patients according to the number of PALN as follows: Group 1 (less than 15 PALN) and Group 2 with more than 15 PALN. All patients received adjuvant systemic therapy according to the clinical guidelines. We analysed number of locoregional (LR) recurrences, distant metastasis, overall survival, progression free survival (PFS) and DMFS. Results. After the median follow-up time of 11.5 years, the Kaplan-Meier survival analysis of PALN showed significantly shorter OS (p = 0.006), shorter PFS (p = 0.002) and shorter DMFS (p < 0.001) in the group of > 15 PALN. Only one LR was found in the group of patients with more than 15 PALN. In multivariate analysis more than 15 PALN and treatment with anthracycline chemotherapy statistically significantly influenced OS and DMFS. For PFS presence of more than 15 PALN were the only independent factor of shorter survival. Conclusions. Patients with more than 15 PALN have shorter DMFS, PFS and OS as compared to patients with less than 15 PALN, though they receive the same LR treatment. More studies with higher number of patients included are needed to further evaluate our findings.
Keywords: radiotherapy, postmastectomy, axillary limph nodes, breast cancer
Published in DiRROS: 10.06.2024; Views: 54; Downloads: 34
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Abstract: Background. Trastuzumab therapy given in combination with one of several chemotherapy regimens is currently considered the standard of care for the treatment of early-stage, human epidermal growth factor receptor-2 (HER2) -positive breast cancer. The treatment with trastuzumab is due to a significant impact on the survival part of the standard adjuvant treatment of patients with HER2-positive breast cancer. Patients treated with postoperative breast or chest wall irradiation receive trastuzumab concomitant with radiotherapy. In a small proportion of patients trastuzumab causes cardiotoxicity. Preclinical findings indicate a radiosensibilizing effect of trastuzumab in breast cancer cells, but it is not yet clear whether it radiosensibilizes cells of healthy tissues too.Conclusions. Special attention is required when left breast or left thoracic wall is irradiated in patient receiving trastuzumab, because long-term effects of the concurrent treatment with trastuzumab and radiotherapy are not yet known. In an era where more patients are surviving a diagnosis of breast cancer, better understanding and earlier detection of therapy-induced cardiac toxicity will be of paramount importance.
Keywords: radiotherapy, cardiotoxicity, trastuzumab, early breast cancer
Published in DiRROS: 11.04.2024; Views: 175; Downloads: 84
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Abstract: Obsevanje je del standardnega zdravljenja bolnic z rakom dojk. Odgovor na zdravljenje z obsevanjem je pri vsakem posamezniku drugačen in je odvisen tudi od genetskih dejavnikov. Eden od novejših genetskih označevalcev odgovora na obsevanje je dolžina telomerov. Telomeri ščitijo kromosome pred krajšanjem in vzdržujejo genomsko stabilnost. Rezultati naše raziskave kažejo, da se dinamika spreminjanja dolžine telomerov takoj po zdravljenju z obsevanjem in v šestih mesecih po obsevanju pri bolnicah z neinvazivnim rakom dojk spreminja in bi lahko služila kot biološki označevalec odgovora na obsevanje. Molekularni mehanizmi, povezani s tem procesom, ostajajo zaenkrat večinoma neraziskani.
Keywords: rak dojk, obsevanje, onkološko zdravljenje
Published in DiRROS: 16.06.2023; Views: 400; Downloads: 191
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Keywords: onkologija, rak dojke, obsevanje
Published in DiRROS: 09.02.2023; Views: 385; Downloads: 121
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Keywords: onkologija, rak dojke, kemoterapija
Published in DiRROS: 27.01.2023; Views: 475; Downloads: 128
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