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Influence of the delay between conservative surgery and radiation therapy on local relapse in node-positive breast tumor Volume 93, issue 3, Mars 2006

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Département de radiothérapie, Centre Eugène Marquis, rue de la Bataille Flandres-Dunkerque, 35042 Rennes, Département de radiothérapie, Institut Claudius Régaud, 20-24, rue du Pont Saint-Pierre, 31052 Toulouse, Département de radiothérapie, Centre René Gauducheau, Boulevard Jacques Monod, 44805 Saint-Herblain, Département de radiothérapie, Centre Oscar Lambret, 3, rue Frédéric-Combemale, 59020 Lille, Département de radiothérapie, Centre hospitalier Jules Courmont, Chemin du Grand Revoyet, 69310 Pierre-Bénite, Département de radiothérapie, Centre Georges-François Leclerc, 1, rue du Professeur Marion, 21079 Dijon, Département de radiothérapie, Centre Antoine Lacassagne, 33 rue de Valombrose, 06189 Nice, Département de radiothérapie et d’oncologie médicale, Centre hospitalier André Boulloche, 25209 Montbéliard, Département de radiothérapie et d’oncologie médicale, Clinique Saint-Vincent, 40, chemin de Tilleroyes, 25000 Besançon, Département de radiothérapie et d’oncologie médicale, Centre hospitalier de Bretagne Sud, 56322 Lorient, Département de radiothérapie, Centre Alexis Vautrin, Avenue de Bourgogne, 54511 Vandœuvre-les-Nancy, Département d’oncologie médicale, Centre Jean Perrin, 58, rue Montalembert, 63011 Clermont-Ferrand, Département d’oncologie médicale, Centre Paul Papin, 2 rue Moll, 49036 Angers, Département de radiothérapie, Centre hospitalier universitaire Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, Département d’oncologie médicale, Centre Henri Becquerel, 1, rue d’Amiens, 76038 Rouen, Département d’oncologie médicale, Centre Eugène Marquis, Rue de la Bataille Flandres-Dunkerque, 35042 Rennes

It has been shown that a delay in radiotherapy (RT) initiation resulted in a higher local relapse (LR) rate. The present analysis investigated retrospectively if the RT-adjuvant therapy sequence modified local-disease-free survival (L-DFS) after breast-conserving surgery (BCS) in node-positive (N +) breast cancer patients. Among seven French Adjuvant Study Group trials, 1,831 patients were assessable : 475 received RT directly after BCS, 567 after the 3 rd chemotherapy (CT) cycle, and 789 after the 6th CT cycle. In the 1,356 patients receiving CT, it consisted of FEC regimens (fluorouracil, epirubicin, cyclophosphamide) in 83.5 % of patients. After a 102-month median follow-up, 214 patients (11.7 %) developed LR. The 9-year L-DFS rates were 92.0 %, 81.5 %, and 87.4 %, respectively (p < 0.0001). In the multivariate analysis, the timing of RT was not associated with a higher rate of LR, whereas tumor size and hormonotherapy were prognostic factors. In our population, there was no increase in the risk of LR when RT was delayed to deliver adjuvant CT. Prognostic factors were tumor size, and hormonotherapy. The number of CT courses could modify this risk.