|By Marketwired .||
|September 24, 2013 08:15 AM EDT||
ATLANTA, GA--(Marketwired - September 24, 2013) - Early-stage breast cancer patients who receive external beam therapy (XRT) are not at higher risk for serious long-term side effects in the chest area, including increase in deaths from cardiac disease and secondary malignancies, according to research presented today at the American Society for Radiation Oncology's (ASTRO's) 55th Annual Meeting.
The study utilized patient information from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database. It evaluated women identified as having primary Stage T1aN0 breast cancer (tumor of 5mm or less that has not spread to the lymph nodes), who received surgery, with or without post-operative radiation therapy, between 1990 and 1997. The analysis was done to determine if XRT was associated with increased mortality due to breast cancer, secondary cancer in the chest area or cardiac conditions for these patients; only patients with breast cancer (BC) identified as the first malignancy were included. The women had a median age of 55-59 and were divided into two groups: 2,397 who received XRT after surgery, and 2,988 who did not receive XRT after surgery.
Cause of death (COD) codes were used to identify cardiac mortality, breast cancer mortality, and deaths from secondary chest cancers in order to assess overall survival (OS), breast cancer survival (BCS), second-tumor specific survival and cardiac-cause specific survival (CCS), and then compared between the XRT and non-XRT groups. The incidence of mortality was compared between the XRT and non-XRT groups utilizing the Chi-Square test; and, the relative risk (RR) and associated 95 percent confidence interval (CI) were calculated. Kaplan-Meier survival analysis and log-rank test were performed to assess OS, BCS, second-tumor specific survival and CCS.
At 10 years post-treatment, OS rates were 91.6 percent for the XRT patients and 87 percent for the non-XRT group; BCS rates were 97 percent for the XRT patients and 95.7 percent for the non-XRT group; and CCS was 96.7 percent for the XRT patients and 92.7 percent for the non-XRT group.
Analysis of the data further demonstrates that, with a median follow up of 14 years, there was no statistically significant difference in deaths from subsequent non-breast cancers in the chest area, the majority of which were lung cancers. The number of deaths from cardiac causes was not significantly higher for those patients treated with XRT for left-sided breast cancer, compared to those with right-sided breast cancer among the patient sample and time period reviewed. More women from the non-XRT group died from all causes, including cardiac causes, suggesting that those patients had worse general health conditions than the women who received radiation therapy.
"Breast conserving therapy, consisting of lumpectomy and XRT, has been an excellent approach to early breast cancer treatment, offering equivalent disease control and better cosmetic results compared to mastectomy as demonstrated by multiple randomized controlled trials in the past," said Jason Ye, MD, the study's presenting author and a second-year resident in radiation oncology at Weill Cornell Medical College in New York City. "Our study's results suggest that serious long-term side effects of radiation therapy, such as increase in deaths from cardiac disease and secondary malignancies, are rare. Radiation therapy is an integral part of early stage breast cancer treatment for those who choose to have a lumpectomy instead of a mastectomy, with its benefits likely far outweighing the potential risks in majority of the cases. The field of radiation oncology is rapidly changing, with new technology constantly being introduced that may reduce these risks further. Continued long term follow up and additional studies are needed to monitor for potential long term side effects."
The abstract, "Breast Cancer (BC), Second Cancer, and Cardiac Mortality in Stage T1aN0 BC Patients with or without External Beam Radiation Therapy (XRT): NCI SEER Study," will be presented in detail during a scientific session at ASTRO's 55th Annual Meeting at 1:00 p.m. Eastern time on Tuesday, September 24, 2013. To speak with Dr. Ye, contact Michelle Kirkwood on September 22-25, 2013, in the ASTRO Press Office at the Georgia World Congress Center in Atlanta at 404-222-5303 or 404-222-5304, or email [email protected].
ASTRO's 55th Annual Meeting, held in Atlanta, September 22-25, 2013, is the premier scientific meeting in radiation oncology and brings together more than 11,000 attendees including oncologists from all disciplines, medical physicists, dosimetrists, radiation therapists, radiation oncology nurses and nurse practitioners, biologists, physician assistants, practice administrators, industry representatives and other health care professionals from around the world. The theme of the 2013 meeting is "Patients: Hope • Guide • Heal" and focuses on patient-centered care and the importance of the physician's role in improving patient-reported outcomes and the quality and safety of patient care. The four-day scientific meeting includes presentation of four plenary papers, 363 oral presentations, 1,460 posters and 144 digital posters in 70 educational sessions and scientific panels for 19 disease sites/tracks. Keynote and featured speakers include: William B. Munier, director of the Center for Quality Improvement and Patient Safety at the Agency for Healthcare Research and Quality; Darrell G. Kirch, MD, president and CEO of the Association of American Medical Colleges; James Cosgrove, PhD, director of the U.S. Government Accountability Office; Otis W. Brawley, MD, chief medical officer of the American Cancer Society; and Peter Friedl, MD, PhD, of St. Radboud University Nijmegen Medical Centre at the University of Nijmegen and MD Anderson Cancer Center.
ASTRO is the premier radiation oncology society in the world, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals that specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, the Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes two medical journals, International Journal of Radiation Oncology • Biology • Physics (www.redjournal.org) and Practical Radiation Oncology (www.practicalradonc.org); developed and maintains an extensive patient website, www.rtanswers.org; and created the Radiation Oncology Institute (www.roinstitute.org), a non-profit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. To learn more about ASTRO, visit www.astro.org.
2013 American Society for Radiation Oncology (ASTRO) 55th Annual Meeting
News Briefing, Tuesday, September 24, 2013, 8:15 a.m. Eastern time
Scientific Session: Tuesday, September 24, 2013, 1:00 - 2:30 p.m. ET, Georgia World Congress Center
110 Publishing Title: Breast Cancer (BC), Second Cancer, and Cardiac Mortality in Stage T1aN0 BC Patients with or without External Beam Radiation Therapy (XRT): NCI SEER Study
J. C. Ye1, W. Yan1, P. J. Christos2, D. Nori1, K. C. Chao1, A. Ravi3, 1New York Presbyterian Hospital/Weill Cornell Medical College, New York, NY, 2Weill Cornell Medical College, New York, NY, 3New York Hospital Queens/Weill Cornell Medical College, New York, NY
Purpose/Objective(s): While studies have shown breast conservation treatment (BCT) incorporating lumpectomy and XRT to be equivalent to mastectomy in overall survival (OS), and BC specific survival (BCS), the potential adverse late effects of XRT to the chest area must be considered. We examined the cardiac mortality and second cancer mortality and the possible association with XRT in patients with the best prognosis BC.
Materials/Methods: All women who had breast conserving surgery or mastectomy with or without adjuvant XRT for Stage T1aN0 breast malignancy in 1990-1997 were identified in the SEER database. Only BC identified as first malignancy was included. Cause of death (COD) codes were used to identify cardiac mortality (cardiac disease and atherosclerosis), BC mortality, and deaths from second cancers in the chest area. The incidence of mortality was compared between the XRT and no-XRT groups using Chi-square test, and the relative risk (RR) and associated 95% confidence interval (CI) were calculated. Kaplan-Meier survival analysis and log-rank test were performed to assess OS, BCS, second tumor specific survival, and cardiac cause specific survival (CCS).
Results: A total of 2397 T1aN0 patients who received XRT after BC surgery and 2988 who did not were included in this study. The median age was similar (55-59 years) for both groups. The median follow up periods were also similar (XRT: 169 mo, no-XRT: 171 mo). Compared to the no-XRT group, XRT group was associated with lower overall mortality (p<0.001, RR 0.69, CI 0.61-0.78), BC mortality (p=0.02, RR 0.75, CI 0.59-0.95), and cardiac mortality (p<0.001, RR 0.53, CI 0.44-0.64). The 10-year OS for XRT and no-XRT groups were 91.6%mo and 87.0%, respectively (p<0.001). The 10-year BCS in the XRT and no- XRT groups was 97.0% and 95.7%, respectively (P=0.01). The 10-year CCS in the XRT and no-XRT groups were 96.7% and 92.7%, respectively (p<0.001). In the XRT group, having left sided BC did not increase the incidence of cardiac mortality compared to right sided BC. There were no statistically significant incidences in mortality due to subsequent lung, esophageal, soft tissue, lymphoma, and leukemic cancers. The most common second cancer mortality included 94 (2%) lung, 24 (0.4%) lymphoma, 21 (0.4%) leukemia, 3 (0.06%) soft tissue including heart, and 2 (0.04%) esophagus.
Conclusions: This review of the SEER data suggests that XRT is not associated with increased mortality due to BC , secondary cancer in the chest area, or cardiac conditions, and supports the continued use of BCT in early stage BC.
Author Disclosure Block: J.C. Ye: None. W. Yan: None. P.J. Christos: None. D. Nori: None. K.C. Chao: None. A. Ravi: None.
The following files are available for download:
Internet of @ThingsExpo, taking place June 6-8, 2017 at the Javits Center in New York City, New York, is co-located with the 20th International Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. @ThingsExpo New York Call for Papers is now open.
Jan. 16, 2017 11:30 PM EST Reads: 3,507
WebRTC has had a real tough three or four years, and so have those working with it. Only a few short years ago, the development world were excited about WebRTC and proclaiming how awesome it was. You might have played with the technology a couple of years ago, only to find the extra infrastructure requirements were painful to implement and poorly documented. This probably left a bitter taste in your mouth, especially when things went wrong.
Jan. 16, 2017 09:00 PM EST Reads: 7,433
Up until last year, enterprises that were looking into cloud services usually undertook a long-term pilot with one of the large cloud providers, running test and dev workloads in the cloud. With cloud’s transition to mainstream adoption in 2015, and with enterprises migrating more and more workloads into the cloud and in between public and private environments, the single-provider approach must be revisited. In his session at 18th Cloud Expo, Yoav Mor, multi-cloud solution evangelist at Cloudy...
Jan. 16, 2017 08:45 PM EST Reads: 4,575
When you focus on a journey from up-close, you look at your own technical and cultural history and how you changed it for the benefit of the customer. This was our starting point: too many integration issues, 13 SWP days and very long cycles. It was evident that in this fast-paced industry we could no longer afford this reality. We needed something that would take us beyond reducing the development lifecycles, CI and Agile methodologies. We made a fundamental difference, even changed our culture...
Jan. 16, 2017 08:00 PM EST Reads: 614
The proper isolation of resources is essential for multi-tenant environments. The traditional approach to isolate resources is, however, rather heavyweight. In his session at 18th Cloud Expo, Igor Drobiazko, co-founder of elastic.io, drew upon his own experience with operating a Docker container-based infrastructure on a large scale and present a lightweight solution for resource isolation using microservices. He also discussed the implementation of microservices in data and application integrat...
Jan. 16, 2017 06:45 PM EST Reads: 3,486
All organizations that did not originate this moment have a pre-existing culture as well as legacy technology and processes that can be more or less amenable to DevOps implementation. That organizational culture is influenced by the personalities and management styles of Executive Management, the wider culture in which the organization is situated, and the personalities of key team members at all levels of the organization. This culture and entrenched interests usually throw a wrench in the work...
Jan. 16, 2017 06:00 PM EST Reads: 366
Containers have changed the mind of IT in DevOps. They enable developers to work with dev, test, stage and production environments identically. Containers provide the right abstraction for microservices and many cloud platforms have integrated them into deployment pipelines. DevOps and containers together help companies achieve their business goals faster and more effectively. In his session at DevOps Summit, Ruslan Synytsky, CEO and Co-founder of Jelastic, reviewed the current landscape of Dev...
Jan. 16, 2017 05:00 PM EST Reads: 4,011
In his General Session at DevOps Summit, Asaf Yigal, Co-Founder & VP of Product at Logz.io, will explore the value of Kibana 4 for log analysis and will give a real live, hands-on tutorial on how to set up Kibana 4 and get the most out of Apache log files. He will examine three use cases: IT operations, business intelligence, and security and compliance. This is a hands-on session that will require participants to bring their own laptops, and we will provide the rest.
Jan. 16, 2017 03:30 PM EST Reads: 4,820
IoT is at the core or many Digital Transformation initiatives with the goal of re-inventing a company's business model. We all agree that collecting relevant IoT data will result in massive amounts of data needing to be stored. However, with the rapid development of IoT devices and ongoing business model transformation, we are not able to predict the volume and growth of IoT data. And with the lack of IoT history, traditional methods of IT and infrastructure planning based on the past do not app...
Jan. 16, 2017 03:15 PM EST Reads: 353
"LinearHub provides smart video conferencing, which is the Roundee service, and we archive all the video conferences and we also provide the transcript," stated Sunghyuk Kim, CEO of LinearHub, in this SYS-CON.tv interview at @ThingsExpo, held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA.
Jan. 16, 2017 02:30 PM EST Reads: 1,549
"We're bringing out a new application monitoring system to the DevOps space. It manages large enterprise applications that are distributed throughout a node in many enterprises and we manage them as one collective," explained Kevin Barnes, President of eCube Systems, in this SYS-CON.tv interview at DevOps at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.
Jan. 16, 2017 02:15 PM EST Reads: 5,267
With major technology companies and startups seriously embracing IoT strategies, now is the perfect time to attend @ThingsExpo 2016 in New York. Learn what is going on, contribute to the discussions, and ensure that your enterprise is as "IoT-Ready" as it can be! Internet of @ThingsExpo, taking place June 6-8, 2017, at the Javits Center in New York City, New York, is co-located with 20th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry p...
Jan. 16, 2017 01:45 PM EST Reads: 3,594
@DevOpsSummit at Cloud taking place June 6-8, 2017, at Javits Center, New York City, is co-located with the 20th International Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The widespread success of cloud computing is driving the DevOps revolution in enterprise IT. Now as never before, development teams must communicate and collaborate in a dynamic, 24/7/365 environment. There is no time to wait for long developm...
Jan. 16, 2017 01:30 PM EST Reads: 3,309
Updating DevOps to the latest production data slows down your development cycle. Probably it is due to slow, inefficient conventional storage and associated copy data management practices. In his session at @DevOpsSummit at 20th Cloud Expo, Dhiraj Sehgal, in Product and Solution at Tintri, will talk about DevOps and cloud-focused storage to update hundreds of child VMs (different flavors) with updates from a master VM in minutes, saving hours or even days in each development cycle. He will also...
Jan. 16, 2017 01:00 PM EST Reads: 1,031
In a recent research, analyst firm IDC found that the average cost of a critical application failure is $500,000 to $1 million per hour and the average total cost of unplanned application downtime is $1.25 billion to $2.5 billion per year for Fortune 1000 companies. In addition to the findings on the cost of the downtime, the research also highlighted best practices for development, testing, application support, infrastructure, and operations teams.
Jan. 16, 2017 01:00 PM EST Reads: 3,647