Azria D, Gourgou S, Sozzi WJ, Zouhair A, Mirimanoff RO, Kramar A, Lemanski C, Dubois JB, Romieu G, Pelegrin A, Ozsahin M, et al.
British journal of cancer. Date of publication 2004 Oct 4;volume 91(7):1251-60.
1. Br J Cancer. 2004 Oct 4;91(7):1251-60.
Concomitant use of tamoxifen with radiotherapy enhances subcutaneous breast
fibrosis in hypersensitive patients.
Azria D(1), Gourgou S, Sozzi WJ, Zouhair A, Mirimanoff RO, Kramar A, Lemanski C,
Dubois JB, Romieu G, Pelegrin A, Ozsahin M.
Author information:
(1)Department of Radiation Oncology, Centre Régional de Lutte contre le Cancer,
Rue Croix Verte, 34298 Montpellier, France. azria@valdorel.fnclcc.fr
Concomitant use of adjuvant tamoxifen (TAM) and radiation therapy (RT) is not
widely accepted. We aim to assess whether this treatment is associated with an
increased risk of developing subcutaneous fibrosis after conservative or radical
surgery in breast cancer patients. We analysed 147 women with breast cancer
treated with adjuvant RT, and who were included in the KFS 00539-9-1997/SKL
00778-2-1999 prospective study aimed at evaluating the predictive value of CD4
and CD8 T-lymphocyte apoptosis for the development of radiation-induced late
effects. TAM (20 mg day(-1)) with concomitant RT was prescribed in 90 hormone
receptor-positive patients. There was a statistically significant difference in
terms of complication-relapse-free survival (CRFS) rates at 3 years, 48% (95% CI
37.2-57.6%) vs 66% (95% CI 49.9-78.6%) and complication-free survival (CFS) rates
at 2 years, 51% (95% CI 40-61%) vs 80% (95% CI 67-89%) in the TAM and no-TAM
groups, respectively. In each of these groups, the CRFS rates were significantly
lower for patients with low levels of CD8 radiation-induced apoptosis, 20% (95%
CI 10-31.9%), 66% (95% CI 51.1-77.6%), and 79% (95% CI 55-90.9%) for CD8 =16,
16-24, and >24%, respectively. Similar results were observed for the CFS rates.
The concomitant use of TAM with RT is significantly associated with an increased
incidence of grade 2 or greater subcutaneous fibrosis; therefore, caution is
needed for radiosensitive patients.
DOI: 10.1038/sj.bjc.6602146
PMCID: PMC2409893
PMID: 15328527 [Indexed for MEDLINE]