دورية أكاديمية
أعرض في EDS

Frequency of Radiation Therapy-Induced Malignancies in Patients With Li-Fraumeni Syndrome and Early-Stage Breast Cancer and the Influence of Radiation Therapy Technique.

التفاصيل البيبلوغرافية
العنوان: Frequency of Radiation Therapy-Induced Malignancies in Patients With Li-Fraumeni Syndrome and Early-Stage Breast Cancer and the Influence of Radiation Therapy Technique.
المؤلفون: Petry V; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Instituto D'Or de Pesquisa e Ensino, São Paulo, Brazil. Electronic address: vanessa.petry@hc.fm.usp.br., Bonadio RC; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Instituto D'Or de Pesquisa e Ensino, São Paulo, Brazil., Moutinho K; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Instituto D'Or de Pesquisa e Ensino, São Paulo, Brazil., Leite LS; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Instituto D'Or de Pesquisa e Ensino, São Paulo, Brazil., Testa L; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Instituto D'Or de Pesquisa e Ensino, São Paulo, Brazil., Cohn DJBH; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil., Cagnacci AC; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil., Kim VEH; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil., Del Pilar Estevez-Diz M; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Instituto D'Or de Pesquisa e Ensino, São Paulo, Brazil., Fragoso MCBV; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil.
المصدر: International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2024 Jul 15; Vol. 119 (4), pp. 1086-1091. Date of Electronic Publication: 2024 Feb 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier, Inc Country of Publication: United States NLM ID: 7603616 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-355X (Electronic) Linking ISSN: 03603016 NLM ISO Abbreviation: Int J Radiat Oncol Biol Phys Subsets: MEDLINE
أسماء مطبوعة: Publication: New York, NY : Elsevier, Inc
Original Publication: Elmsford, N. Y., Pergamon Press.
مواضيع طبية MeSH: Li-Fraumeni Syndrome*/genetics , Breast Neoplasms*/radiotherapy , Neoplasms, Radiation-Induced*/etiology, Humans ; Female ; Adult ; Middle Aged ; Young Adult ; Radiotherapy, Adjuvant/adverse effects ; Radiotherapy, Intensity-Modulated/adverse effects ; Radiotherapy Dosage ; Germ-Line Mutation ; Tumor Suppressor Protein p53/genetics ; Neoplasm Recurrence, Local ; Incidence
مستخلص: Purpose: Breast cancer (BC) is the most common malignancy in female patients with Li-Fraumeni syndrome (LFS), a condition associated with an increased risk of various malignancies, including radiation therapy (RT)-induced malignancies (RIM) within previously irradiated areas. Our study aimed to assess the incidence of RIM in patients with LFS and early-stage BC treated with adjuvant RT, including the effect of RT dose and technique.
Methods and Materials: We examined patients with a germline pathogenic/likely pathogenic TP53 variant diagnosed with early-stage BC and monitored by a hereditary cancer team at a single cancer center. The study endpoints included RIM frequency, the association of RIM with the dose and type of RT (2-dimensional [2D] RT, 3-dimensional [3D] RT, and intensity modulated RT [IMRT]), and BC recurrence.
Results: We analyzed 48 patients with a median age of 39 years (range, 21-62). The majority (71%) had the TP53 R337H variant, and 87% were unaware of their LFS diagnosis at the time of BC treatment. Treatment modalities included mastectomy (62%), (neo)adjuvant chemotherapy (66%), and RT (62%), with RT being more common after breast-conserving surgery (87% vs 46% with mastectomy, P = .010). Among the 30 patients treated with RT, 10% developed RIM in the irradiated field, consisting of 3 soft tissue malignancies. RT dose (≤40.8 or >40.8 Gy) did not influence RIM occurrence, but the type of RT did. RIM was observed in 100% of cases with 2D RT (2/2), 50% with IMRT (1/2), and 0% with 3D RT (0/16) (P = .004).
Conclusions: Our study underscores a concerning rate of RIM after adjuvant RT, emphasizing the importance of a thorough risk-benefit evaluation before recommending RT, with preference for its avoidance if possible. Although subgroup sizes were limited, the risk of RIM appeared to be influenced by the RT technique, with higher rates observed with 2D RT and IMRT compared with 3D RT. Early TP53 testing is essential to guide the BC treatment plan.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
المشرفين على المادة: 0 (Tumor Suppressor Protein p53)
تواريخ الأحداث: Date Created: 20240203 Date Completed: 20240626 Latest Revision: 20240627
رمز التحديث: 20240628
DOI: 10.1016/j.ijrobp.2024.01.204
PMID: 38309330
قاعدة البيانات: MEDLINE
الوصف
تدمد:1879-355X
DOI:10.1016/j.ijrobp.2024.01.204