Radiation-induced CD8 T-lymphocyte Apoptosis as a Predictor of Breast Fibrosis After Radiotherapy: Results of the Prospective Multicenter French Trial
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Titre | Radiation-induced CD8 T-lymphocyte Apoptosis as a Predictor of Breast Fibrosis After Radiotherapy: Results of the Prospective Multicenter French Trial |
Type de publication | Journal Article |
Year of Publication | 2015 |
Auteurs | Azria D, Riou O, Castan F, Nguyen TDat, Peignaux K, Lemanski C, Lagrange J-L, Kirova Y, Lartigau E, Belkacemi Y, Bourgier C, Rivera S, Noel G, Clippe S, Mornex F, Hennequin C, Kramar A, Gourgou S, Pelegrin A, Fenoglietto P, Ozsahin EMahmut |
Journal | EBIOMEDICINE |
Volume | 2 |
Pagination | 1965-1973 |
Date Published | DEC |
Type of Article | Article |
ISSN | 2352-3964 |
Mots-clés | Apoptosis, Breast fibrosis, lymphocyte, Prediction, radiotherapy |
Résumé | {Background: Monocentric cohorts suggested that radiation-induced CD8 T-lymphocyte apoptosis (RILA) can predict late toxicity after curative intent radiotherapy (RT). We assessed the role of RILA as a predictor of breast fibrosis (bf+) after adjuvant breast RT in a prospective multicenter trial. Methods: A total of 502 breast-cancer patients (pts) treated by conservative surgery and adjuvant RT were recruited at ten centers. RILA was assessed before RT by flow cytometry. Impact of RILA on bf+(primary endpoint) or relapse was assessed using a competing risk method. Receiver-operator characteristic (ROC) curve analyses were also performed in intention to treat. This study is registered with ClinicalTrials. gov, number NCT00893035 and final analyses are presented here. Findings: Four hundred and fifty-six pts (90.8%) were included in the final analysis. One hundred and eight pts (23.7%) received whole breast and node irradiation. A boost dose of 10-16 Gy was delivered in 449 pts (98.5%). Adjuvant hormonotherapy was administered to 349 pts (76.5%). With a median follow-up of 38.6 months, grade >= 2 bf+ was observed in 64 pts (14%). A decreased incidence of grade >= 2 bf+ was observed for increasing values of RILA (p = 0.012). No grade 3 bf+ was observed for patients with RILA = 12%. The area under the ROC curve was 0.62. For cut-off values of RILA = 20% and b12%, sensitivity and specificity were 80% and 34%, 56% and 67%, respectively. Negative predictive value for grade >= 2 bf+ was equal to 91% for RILA >= 20% and positive predictive value was equal to 22% for RILA b12% where the overall prevalence of grade >= 2 bf+ was estimated at 14%. A significant decrease in the risk of grade >= 2 bf+ was found if patients had no adjuvant hormonotherapy (sHR= 0.31 |
DOI | 10.1016/j.ebiom.2015.10.024 |