Neoadjuvant Radiotherapy for Early-Stage Breast Cancer
Jan Poleszczuk, PhD, of H. Lee Moffitt Cancer Center and Research Institute, and colleagues have found that neoadjuvant radiotherapy may improve disease-free survival without reducing overall survival, particularly in women with early-stage estrogen receptor–positive breast cancer. Their study findings, which were published in Breast Cancer Research, suggest further study of the potential long-term benefits of neoadjuvant radiotherapy in a controlled clinical trial setting may be warranted.
Using data from the Surveillance, Epidemiology, and End Results (SEER) database, the investigators identified 250,195 women with early-breast cancer who received radiotherapy. Most of them (99%) were treated with radiotherapy after surgery, whereas the remaining patients were treated with radiotherapy before surgery.
Partial mastectomy was performed in 94% of the study patients, with the remaining 6% undergoing complete mastectomy. The hazard ratio of developing a second primary tumor after neoadjuvant compared with adjuvant radiotherapy was 0.64 in the largest cohort: women with estrogen receptor–positive breast cancer who had partial mastectomy. Overall survival appeared to be independent of radiation sequence (hazard ratio = 1).