| Added by | Nathalie Bonnefoy |
|---|---|
| Group name | EquipeNB |
| Item Type | Journal Article |
| Title | Radiation-induced CD8 T-lymphocyte Apoptosis as a Predictor of Breast Fibrosis After Radiotherapy: Results of the Prospective Multicenter French Trial |
| Creator | Azria et al. |
| Author | David Azria |
| Author | Olivier Riou |
| Author | Florence Castan |
| Author | Tan Dat Nguyen |
| Author | Karine Peignaux |
| Author | Claire Lemanski |
| Author | Jean-Léon Lagrange |
| Author | Youlia Kirova |
| Author | Eric Lartigau |
| Author | Yazid Belkacemi |
| Author | Céline Bourgier |
| Author | Sofia Rivera |
| Author | Georges Noël |
| Author | Sébastien Clippe |
| Author | Françoise Mornex |
| Author | Christophe Hennequin |
| Author | Andrew Kramar |
| Author | Sophie Gourgou |
| Author | André Pèlegrin |
| Author | Pascal Fenoglietto |
| Author | Esat Mahmut Ozsahin |
| Abstract | BACKGROUND: Monocentric cohorts suggested that radiation-induced CD8 T-lymphocyte apoptosis (RILA) can predict late toxicity after curative intent radiotherapy (RT). We assessed the role of RILA as a predictor of breast fibrosis (bf +) after adjuvant breast RT in a prospective multicenter trial. METHODS: A total of 502 breast-cancer patients (pts) treated by conservative surgery and adjuvant RT were recruited at ten centers. RILA was assessed before RT by flow cytometry. Impact of RILA on bf + (primary endpoint) or relapse was assessed using a competing risk method. Receiver-operator characteristic (ROC) curve analyses were also performed in intention to treat. This study is registered with ClinicalTrials.gov, number NCT00893035 and final analyses are presented here. FINDINGS: Four hundred and fifty-six pts (90.8%) were included in the final analysis. One hundred and eight pts (23.7%) received whole breast and node irradiation. A boost dose of 10-16 Gy was delivered in 449 pts (98.5%). Adjuvant hormonotherapy was administered to 349 pts (76.5%). With a median follow-up of 38.6 months, grade ? 2 bf + was observed in 64 pts (14%). A decreased incidence of grade ? 2 bf + was observed for increasing values of RILA (p = 0.012). No grade 3 bf + was observed for patients with RILA ? 12%. The area under the ROC curve was 0.62. For cut-off values of RILA ? 20% and < 12%, sensitivity and specificity were 80% and 34%, 56% and 67%, respectively. Negative predictive value for grade ? 2 bf + was equal to 91% for RILA ? 20% and positive predictive value was equal to 22% for RILA < 12% where the overall prevalence of grade ? 2 bf + was estimated at 14%. A significant decrease in the risk of grade ? 2 bf + was found if patients had no adjuvant hormonotherapy (sHR = 0.31, p = 0.007) and presented a RILA ? 12% (sHR = 0.45, p = 0.002). INTERPRETATION: RILA significantly predicts the risk of breast fibrosis. This study validates the use of RILA as a rapid screening test before RT delivery and will change definitely our daily clinical practice in radiation oncology. FUNDING: The French National Cancer Institute (INCa) through the "Program Hospitalier de Recherche Clinique (PHRC)". |
| Publication | EBioMedicine |
| Volume | 2 |
| Issue | 12 |
| Pages | 1965-1973 |
| Date | Dec 2015 |
| Journal Abbr | EBioMedicine |
| Language | eng |
| DOI | 10.1016/j.ebiom.2015.10.024 |
| ISSN | 2352-3964 |
| Short Title | Radiation-induced CD8 T-lymphocyte Apoptosis as a Predictor of Breast Fibrosis After Radiotherapy |
| Library Catalog | PubMed |
| Extra | PMID: 26844275 PMCID: PMC4703704 |
| Tags | Adult, Aged, Aged, 80 and over, Apoptosis, Biomarkers, Tumor, Breast fibrosis, Breast Neoplasms, CD8-Positive T-Lymphocytes, clinic, Female, Fibrocystic Breast Disease, Fibrosis, Humans, Incidence, Middle Aged, Neoplasm Grading, Neoplasm Staging, Prediction, Prognosis, Proportional Hazards Models, Radiotherapy, Radiotherapy, Adjuvant, Recurrence, Risk Factors |
| Date Added | 2019/05/28 - 22:09:35 |
| Date Modified | 2019/05/28 - 22:09:50 |
| Notes and Attachments | PubMed entry (Attachment) Texte intégral (Attachment) |
Institut de Recherche en Cancérologie de
