Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. Jul 28, 2012; 4(7): 318-323
Published online Jul 28, 2012. doi: 10.4329/wjr.v4.i7.318
Concurrent use of aromatase inhibitors and hypofractionated radiation therapy
Cyrus Chargari, Pablo Castro-Pena, Ivan Toledano, Marc A Bollet, Alexia Savignoni, Paul Cottu, Fatima Laki, François Campana, Alain Fourquet, Youlia M Kirova
Cyrus Chargari, Pablo Castro-Pena, Ivan Toledano, Marc A Bollet, François Campana, Alain Fourquet, Youlia M Kirova, Patricia De Cremoux, Department of Radiation Oncology, Institut Curie, 75005 Paris, France
Alexia Savignoni, Department of Biostatistics, Institut Curie, 75005 Paris, France
Paul Cottu, Department of Medical Oncology, Institut Curie 75005 Paris, France
Fatima Laki, Department of Surgery, Institut Curie, 75005 Paris, France
Patricia De Cremoux, Department of Pathology, Institut Curie, 75005 Paris, France
Author contributions: Kirova YM and Savignoni A designed the study; Castro-Pena P, Toledano I, Bollet MA, Savignoni A, Campana F, De Cremoux P, Fourquet A and Kirova YM contributed to acquisition of data; Chargari C, Savignoni A, Campana F, De Cremoux P, Fourquet A and Kirova YM interpreted the data; Chargari C and Kirova YM wrote the paper and revised it; and all authors approved the final version of the version to be published.
Correspondence to: Youlia M Kirova, MD, Department of Radiation Oncology, Institut Curie, 26, rue d’Ulm, 75005 Paris, France. youlia.kirova@curie.net
Telephone: +331-4432-4193 Fax: +331-4432-4616
Received: January 15, 2011
Revised: April 13, 2012
Accepted: April 20, 2012
Published online: July 28, 2012
Abstract

AIM: To retrospectively assess the acute and long-term toxicity using aromatase inhibitors (AI) therapy concurrently with hypofractionated radiotherapy (HFRT) in breast cancer patients.

METHODS: From November 1999 to October 2007, 66 patients were treated with breast HFRT and concurrent AI. In 63 patients (95.5%), HFRT delivered a total dose of 32.5 Gy to the whole breast within 5 wk (five fractions, one fraction per week). Other fractionations were chosen in three patients for the patients’ personal convenience. A subsequent boost to the tumor bed was delivered in 35 patients (53.0%). Acute toxicities were scored according to the Common Toxicity Criteria for Adverse Events v3. Late toxicity was defined as any toxicity occurring more than 6 mo after completion of HFRT and was scored according to the Late Effects Normal Tissue Task Force-Subjective, Objective, Management and Analytic scale.

RESULTS: At the end of the HFRT course, 19 patients (28.8%) had no irradiation-related toxicity. Acute grade 1-2 epithelitis was observed in 46 patients (69.7%). One grade 3 toxicity (1.5%) was observed. With a median follow-up of 34 mo (range: 12-94 mo), 31 patients (47%) had no toxicity, and 35 patients (53%) presented with grade 1-2 fibrosis. No grade 3 or greater delayed toxicity was observed.

CONCLUSION: We found that AI was well tolerated when given concurrently with HFRT. All toxicities were mild to moderate, and no treatment disruption was necessary. Further prospective assessment is warranted.

Keywords: Breast cancer; Hypofractionated radiotherapy; Skin toxicity; Aromatase inhibitors