Is radiotherapy feasible before breast reconstruction?
- Aspirin: Study Finds Greater Benefits for These Colorectal Cancer Patients
- Cancer Can Occur Without Genetic Mutations?
- Statins Lower Blood Lipids: How Long is a Course?
- Warning: Smartwatch Blood Sugar Measurement Deemed Dangerous
- Mifepristone: A Safe and Effective Abortion Option Amidst Controversy
- Asbestos Detected in Buildings Damaged in Ukraine: Analyzed by Japanese Company
Is radiotherapy feasible before breast reconstruction?
- Red Yeast Rice Scare Grips Japan: Over 114 Hospitalized and 5 Deaths
- Long COVID Brain Fog: Blood-Brain Barrier Damage and Persistent Inflammation
- FDA has mandated a top-level black box warning for all marketed CAR-T therapies
- Can people with high blood pressure eat peanuts?
- What is the difference between dopamine and dobutamine?
- How long can the patient live after heart stent surgery?
Is radiotherapy feasible before breast reconstruction? PRADA results announced.
Lancet Oncolony 丨 Primary radiotherapy and deep inferior epigastric perforator flap reconstruction (PRADA) in breast cancer patients: a multicenter, prospective, nonrandomized, feasibility study
Background: Pre-mastectomy radiotherapy and autologous free flap breast reconstruction can avoid adverse radiation effects on healthy donor tissue and delay adjuvant radiotherapy.
However, there is little evidence for this sequence of treatment. We aimed to investigate the feasibility of preoperative radiotherapy followed by skin-sparing mastectomy and deep inferior epigastric perforator (DIEP) flap reconstruction in breast cancer patients requiring mastectomy.
METHODS: We conducted a prospective, nonrandomized feasibility study at two National Health Service Trusts in the United Kingdom. Eligible patients were women older than 18 years with laboratory-diagnosed primary breast cancer requiring mastectomy and post-mastectomy radiotherapy who were candidates for DIEP flap reconstruction.
Preoperative radiotherapy was started 3-4 weeks after neoadjuvant chemotherapy and irradiated the breast in 15 fractions of 40 Gy (over 3 weeks) or 42.72 Gy in 16 fractions (over 3.2 weeks) as needed, plus regional lymph nodes as needed.
Adverse cutaneous radiation toxicity was assessed preoperatively using the Radiation Therapy Oncology Group Toxicity Grading System.
Skin-sparing mastectomy and DIEP flap reconstruction were planned 2-6 weeks after completion of preoperative radiotherapy.
The primary endpoint was the proportion of open breast wounds greater than 1 cm in width that required bandaging at 4 weeks postoperatively as assessed in all participants.
This study is registered with ClinicalTrials.gov, NCT02771938, and recruitment has stopped.
Results:
- Between January 25, 2016, and December 11, 2017, a total of 33 patients were enrolled.
- Four out of 33 patients (12.1%, 95% CI: 3.4–28.2) had an open breast wound greater than 1 cm at 4 weeks postoperatively. Confluent wet desquamation (grade 3) was present in 1 (3%) patient.
- There were no treatment-related serious adverse events and no treatment-related deaths.
CONCLUSIONS:
Skin-sparing mastectomy and immediate DIEP flap reconstruction after preoperative radiotherapy is feasible and technically safe, with rates of open breast wounds similar to those reported for post-mastectomy radiotherapy.
A randomized trial comparing preoperative radiotherapy with postmastectomy radiotherapy is needed to precisely determine and compare surgical, oncological, and breast reconstruction outcomes, including quality of life.
(source:internet, reference only)
Disclaimer of medicaltrend.org
Important Note: The information provided is for informational purposes only and should not be considered as medical advice.
