Survival outcomes of advanced breast cancer patients treated with palliative external beam radiotherapy in the University College Hospital, Ibadan
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Abstract
Background: Numerous randomised controlled trials had proven the effectiveness of palliative external beam radiotherapy (PRT) in symptom relief and improvement in the quality of life for patients with either locally advanced or metastatic breast cancer. However, reports on patient survival after PRT treatment are limited and disease site specific. The aim of this study is to find the effect of metastatic sites and the impact of dose fractionation schemes on the survival of breast cancer patients after PRT treatment.
Methods: We retrospectively reviewed patients’ data with both locally advanced and metastatic breast cancers that were treated with palliative radiotherapy between 2005 and 2009. Radiotherapy doses ranging between 5 and 35 Gy/2.5 and 8 Gy per fraction were used for the treatment. Patients’ survivals were evaluated using Kaplan–Meier method and Cox hazard ratio. Actuarial survival rates were also conducted for 1, 2 and 3 years after PRT.
Results: Five hundred and eighty-four patients were eligible during the study period. Their mean age was 45.9 years. Only 0.7% were males. More than two-thirds of the patients (72.1%) presented with metastatic disease and 34.9% of them had multiple sites of metastasis. The most common prescribed radiation doses and their fractionation numbers ranged between 13 and 28 Gy in 4–9 fractions. Visceral sites of metastasis were significantly associated with poor survival, and treatment with longer radiation courses(≥21 Gy/≥7#) has a significant survival advantage. An actuarial survival rate of 85% of patients was observed beyond 1st year after PRT.
Conclusion: Sites of metastasis have a significant impact on survivals of breast cancer patients, with better survivals among patients with bone and soft-tissue locations compared to those located in the visceral organs. PRT treatment with longer dose fractionation schemes has a significant survival benefit in advanced breast cancer patients.
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