BACKGROUND: Boost radiotherapy (B-RT) improves outcome in patients (pts) with invasive breast cancer. It's use in patients with pure ductal carcinoma in situ (DCIS) is unclear. There are two ongoing randomize trials, results are expected in ten years. Twelve retrospective observational studies have been published since 2006, the recent meta-analysis, support boost in the presence of positive margins. PATIENTS and METHODS: We analyse a retrospective women's cohort of 646 pure DCIS patients (pts) treated mainly in two Hospitals (n=518) from 1993 to 2014. The other ten Hospitals included 128 pts all 2005 long. Proportions were compared by boost status, using the chi-square tests. The impact of boost radiation on the development of local recurrence (LR) was determined using survival analyses. In the comparison of Kaplan-Meier (K-M) was used log-rank test. RESULTS: B-RT subgroup is 394 pts (61%), noB-RT 252 (39%). Median follow-up (FU) is 8.8 years. High risk factors: young age, size, margin status and tamoxifen (TMX) show differences among B-RT (p<0.05). 46% were Estrogen Receptor positive (ER+), 30% B-RT and 16% noB-RT. 22% RE+ in B-RT take TMX vs 9.4 % RE+ noB-RT. Total LR 65 (10%). In situ LR 30 pts (4,6%) and Invasive (Inv) 35 (5,4%). By subgroup, LR in B-RT 47 (12%) vs. 18 (7%) in noB-RT. By subtype, In situ LR in B-RT 20 (5.1%) vs. noB-RT 10 (4%). Inv LR in B-RT 27 (6.9%) vs. noB-RT 8 (3.2%). In uni & multivariate analysis, tumour size, Re-Excision, and TMX, are significant LR risk factors (p<0.05). Boost total doses >16 Gy in the B-RT subgroup is a LR significant risk factor related to 10-16 Gy (p∼0.05). TMX and Dose Boost are related (p<0.001). When Dose is introduced in multivariate analysis model, TMX lost signification. Contralateral local recurrence (CLR) in 29 pts (7%). Second tumours 9 pts (NSD between subgroups). Global disease free survival (DFS) is 80.5%, 77% in B-RT vs. 85% in noB-RT. Four pts have a LR combined with CLR; 2 pts have a LR and a second tumor; 1 pt with CLR and second tumour; 1 pt a Inv regional recurrence; 1 pt mixosarcoma in ipsilateral breast and lung metastases. Deaths: 3 pts (0.5%) after an Inv LR; 3 pts (0.5%) after Inv CR; 20 pts other causes; 10 pts lost their FU. Median FU in B-RT subgroup was 9y vs. 8.3y in noB-RT. The maximum FU according LR in B-RT is 20.6y vs. 17.4y in noB-RT. RL is not significant according to Boost (K-M p=0.398). Median LR in situ or inv depending of B-RT vs. noB-RT shows NSD (p=0.663). CONCLUSIONS: In this large cohort retrospective study with long-term follow-up B-RT was associated with similar LR as noB-RT despite being used more frequently with higher risk disease. Dose boost >16 Gy has a protective effect. Tamoxifen and boost dose are related variables. Further evidence, based on ongoing randomized trials results is essential. Citation Format: Cambra MJ, Moreno F, Sanz X, Anglada L, Moià M, Reyes V, Arenas M, Pedro A, Ballester R, García V, Sanjosé S, Cusidó M, Jimenez C, Macià M, Solé JM, Farrus B. Study of boost radiotherapy's influence on local control in 646 pure ductal carcinoma in situ breast cancer with long-term follow-up. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-17-08.
Background In RA patients, where biological therapy is needed, combination therapy (CT) with a biological agent plus MTX remains the standard of care. However, in some scenarios (i.e. DMARD intolerance, non-compliance) BMT appears as a therapeutic option. Objectives To assess the proportion of RA patients that is currently being treated with BMT in our country and to analyze the reasons behind this treatment pattern. Methods This is a cross-sectional analysis of data obtained from medical charts revision of RA patients. Proportion of patients, reasons for BMT utilization, physician’s satisfaction with BMT outcomes and main causes of DMARD discontinuation were assessed. Results This investigation involved 1148 patients from 32 sites distributed around the country. Main demographic characteristics were: age 54 ± 13 years, 81% female, mean disease duration 12 ± 9 years. Patients receiving BMT represented 21.4% (CI 95%:19-23) of the sample size (246/1148 patients) Conclusions A significant proportion of RA patients in our country are treated with BMT. BMT treatment seems to be an accepted therapeutic option in our medical community, both as initial therapy or as part of a sparing strategy. Patterns of BMT for RA patients in a developing country seem to be similar than those observed in developed countries. References Soliman MM, et al. Ann Rheum Dis2011; 70:583–589. Lee SJ, et al. J Rheumatol2009; 36:1161–7 Acknowledgements Disclosure of Interest E. Mysler Grant/research support from: Roche Argentina, A. Alvarellos Grant/research support from: Roche Argentina, A. Borgia Grant/research support from: Roche Argentina, A. Eimon Grant/research support from: Roche Argentina, R. García Salinas Grant/research support from: Roche Argentina, L. Najún Dubos Employee of: Roche Argentina, L. Re Employee of: Roche Argentina, D. Siri Grant/research support from: Roche Argentina, J. Solé Employee of: Roche Argentina, F. Sommerfleck Grant/research support from: Roche Argentina, J. Velasco Zamora Grant/research support from: Roche Argentina, C. Wiederhold Grant/research support from: Roche Argentina
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