Abstract
The role of postoperative radiotherapy in breast-conserving therapy is undisputed. However, optimal timing of adjuvant radiotherapy is an issue of ongoing debate. This retrospective clinical cohort study was performed to investigate the impact of a delay in surgery-radiotherapy intervals on local control and overall survival. Data from an unselected cohort of 1393patients treated at a single institution over a 17-year period (1990-2006) were analyzed. Patients were assigned to two groups (CT+/CT-) according to chemotherapy status. A delay in the initiation of radiotherapy was defined as > 7weeks (CT- group) and > 24weeks (CT+ group). The 10-year regional recurrence-free survival for the CT- and CT+ groups were 95.6 and 86.0 %, respectively. A significant increase in the median surgery-radiotherapy interval was observed over time (CT- patients: median of 5weeks in 1990-1992 to a median of 6weeks in 2005-2006; CT+ patients: median of 5weeks in 1990-1992 to a median of 21weeks in 2005-2006). There was no association between a delay in radiotherapy and an increased local recurrence rate (CT- group: p = 0.990 for intervals 0-6weeks vs. ≥ 7weeks; CT+ group: p = 0.644 for intervals 0-15weeks vs. ≥ 24 weeks) or decreased overall survival (CT- group: p = 0.386 for intervals 0-6weeks vs. ≥ 7weeks; CT+ group: p = 0.305 for intervals 0-15weeks vs. ≥ 24weeks). In the present cohort, a delay of radiotherapy was not associated with decreased local control or overall survival in the two groups (CT-/CT+). However, in the absence of randomized evidence, delays in the initiation of radiotherapy should be avoided.
Published Version
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