| Added by | mollevi |
|---|---|
| Last modified by | André Pèlegrin |
| Group name | EquipeAP |
| 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 | D. Azria |
| Author | O. Riou |
| Author | F. Castan |
| Author | T. D. Nguyen |
| Author | K. Peignaux |
| Author | C. Lemanski |
| Author | J. L. Lagrange |
| Author | Y. Kirova |
| Author | E. Lartigau |
| Author | Y. Belkacemi |
| Author | C. Bourgier |
| Author | S. Rivera |
| Author | G. Noel |
| Author | S. Clippe |
| Author | F. Mornex |
| Author | C. Hennequin |
| Author | A. Kramar |
| Author | S. Gourgou |
| Author | A. Pelegrin |
| Author | P. Fenoglietto |
| Author | E. M. 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 |
| Pages | 1965-73 |
| Date | Dec 2015 |
| Journal Abbr | EBioMedicine |
| DOI | 10.1016/j.ebiom.2015.10.024 |
| ISSN | 2352-3964 (Electronic) 2352-3964 (Linking) |
| Tags | Equipe, original, top |
| Date Added | 2018/07/20 - 10:01:50 |
| Date Modified | 2019/11/15 - 13:14:27 |
| Notes and Attachments | (Note) (Note) (Note) (Note) 26844275 (Attachment) 26844275 (Attachment) |
Institut de Recherche en Cancérologie de
