Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer
<p>Abstract</p> <p>Background</p> <p>Despite broad advances in multimodal treatment of locally advanced breast cancer (LABC), 30 to 40% of patients develop loco-regional relapse. The aim of this study was to analyze in a retrospective manner the effectiveness of concurr...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2009-07-01
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| Series: | Radiation Oncology |
| Online Access: | http://www.ro-journal.com/content/4/1/24 |
| _version_ | 1811250847799050240 |
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| author | Zinser-Sierra Juan Bargallo-Rocha Enrique Morales-Barrera Rafael Saavedra-Perez David Gamboa-Vignolle Carlos Arrieta Oscar Alvarado-Miranda Alberto Perez-Sanchez Victor Ramirez-Ugalde Teresa Lara-Medina Fernando |
| author_facet | Zinser-Sierra Juan Bargallo-Rocha Enrique Morales-Barrera Rafael Saavedra-Perez David Gamboa-Vignolle Carlos Arrieta Oscar Alvarado-Miranda Alberto Perez-Sanchez Victor Ramirez-Ugalde Teresa Lara-Medina Fernando |
| author_sort | Zinser-Sierra Juan |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Despite broad advances in multimodal treatment of locally advanced breast cancer (LABC), 30 to 40% of patients develop loco-regional relapse. The aim of this study was to analyze in a retrospective manner the effectiveness of concurrent chemo-radiotherapy (CCRTh) after neoadjuvant chemotherapy (NCT) in patients with LABC.</p> <p>Methods</p> <p>One hundred twelve patients with LABC (stage IIB-IIIB) were treated with NCT (5-fluorouracil 500 mg/m<sup>2</sup>, doxorubicin 50 mg/m<sup>2</sup>, and cyclophosphamide 500 mg/m<sup>2 </sup>(FAC), or doxorubicin 50 mg/m<sup>2 </sup>and cyclophosphamide 500 mg/m<sup>2 </sup>(AC) IV in four 21-day courses) followed by CCRTh (60 Gy breast irradiation and weekly mitomycin 5 mg/m<sup>2</sup>, 5-fluorouracil 500 mg/m<sup>2</sup>, and dexamethasone 16 mg, or cisplatin 30 mg/m<sup>2</sup>, gemcitabine 100 mg/m<sup>2 </sup>and dexamethasone 16 mg), and 6–8 weeks later, surgery and two additional courses of FAC, AC, or paclitaxel 90 mg/m<sup>2 </sup>weekly for 12 weeks, and in case of estrogen-receptor positive patients, hormonal therapy.</p> <p>Results</p> <p>Stages IIB, IIIA and -B were 21.4, 42.9, and 35.7%, respectively. Pathological complete response (pCR) in the breast was 42% (95% CI, 33.2–50.5%) and, 29.5% (95% CI, 21.4–37.5%) if including both the breast and the axillary nodes. Multivariate analysis showed that the main determinant of pCR was negative estrogen-receptor status (HR = 3.8; 95% CI, 1.5–9; <it>p </it>= 0.016). The 5-year disease-free survival (DFS) was 76.9% (95% CI, 68.2–84.7%). No relationship between pCR and DFS was found. Multivariate analysis demonstrated that the main DFS determinant was clinical stage (IIB and IIIA <it>vs. </it>IIIB, HR = 3.1; 95% CI, 1.02–9.74; <it>p </it>= 0.04). Only one patient had local recurrence. Five-year overall survival was 84.2% (95% CI, 75–93.2%). The toxicity profile was acceptable.</p> <p>Conclusion</p> <p>This non-conventional multimodal treatment has good loco-regional control for LABC. Randomized clinical trials of preoperative CCRTh following chemotherapy, in patients with LABC are warranted.</p> |
| first_indexed | 2024-04-12T16:10:51Z |
| format | Article |
| id | doaj.art-41caecbb86fb444a85c06dbd4d7969d7 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-04-12T16:10:51Z |
| publishDate | 2009-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-41caecbb86fb444a85c06dbd4d7969d72022-12-22T03:25:54ZengBMCRadiation Oncology1748-717X2009-07-01412410.1186/1748-717X-4-24Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancerZinser-Sierra JuanBargallo-Rocha EnriqueMorales-Barrera RafaelSaavedra-Perez DavidGamboa-Vignolle CarlosArrieta OscarAlvarado-Miranda AlbertoPerez-Sanchez VictorRamirez-Ugalde TeresaLara-Medina Fernando<p>Abstract</p> <p>Background</p> <p>Despite broad advances in multimodal treatment of locally advanced breast cancer (LABC), 30 to 40% of patients develop loco-regional relapse. The aim of this study was to analyze in a retrospective manner the effectiveness of concurrent chemo-radiotherapy (CCRTh) after neoadjuvant chemotherapy (NCT) in patients with LABC.</p> <p>Methods</p> <p>One hundred twelve patients with LABC (stage IIB-IIIB) were treated with NCT (5-fluorouracil 500 mg/m<sup>2</sup>, doxorubicin 50 mg/m<sup>2</sup>, and cyclophosphamide 500 mg/m<sup>2 </sup>(FAC), or doxorubicin 50 mg/m<sup>2 </sup>and cyclophosphamide 500 mg/m<sup>2 </sup>(AC) IV in four 21-day courses) followed by CCRTh (60 Gy breast irradiation and weekly mitomycin 5 mg/m<sup>2</sup>, 5-fluorouracil 500 mg/m<sup>2</sup>, and dexamethasone 16 mg, or cisplatin 30 mg/m<sup>2</sup>, gemcitabine 100 mg/m<sup>2 </sup>and dexamethasone 16 mg), and 6–8 weeks later, surgery and two additional courses of FAC, AC, or paclitaxel 90 mg/m<sup>2 </sup>weekly for 12 weeks, and in case of estrogen-receptor positive patients, hormonal therapy.</p> <p>Results</p> <p>Stages IIB, IIIA and -B were 21.4, 42.9, and 35.7%, respectively. Pathological complete response (pCR) in the breast was 42% (95% CI, 33.2–50.5%) and, 29.5% (95% CI, 21.4–37.5%) if including both the breast and the axillary nodes. Multivariate analysis showed that the main determinant of pCR was negative estrogen-receptor status (HR = 3.8; 95% CI, 1.5–9; <it>p </it>= 0.016). The 5-year disease-free survival (DFS) was 76.9% (95% CI, 68.2–84.7%). No relationship between pCR and DFS was found. Multivariate analysis demonstrated that the main DFS determinant was clinical stage (IIB and IIIA <it>vs. </it>IIIB, HR = 3.1; 95% CI, 1.02–9.74; <it>p </it>= 0.04). Only one patient had local recurrence. Five-year overall survival was 84.2% (95% CI, 75–93.2%). The toxicity profile was acceptable.</p> <p>Conclusion</p> <p>This non-conventional multimodal treatment has good loco-regional control for LABC. Randomized clinical trials of preoperative CCRTh following chemotherapy, in patients with LABC are warranted.</p>http://www.ro-journal.com/content/4/1/24 |
| spellingShingle | Zinser-Sierra Juan Bargallo-Rocha Enrique Morales-Barrera Rafael Saavedra-Perez David Gamboa-Vignolle Carlos Arrieta Oscar Alvarado-Miranda Alberto Perez-Sanchez Victor Ramirez-Ugalde Teresa Lara-Medina Fernando Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer Radiation Oncology |
| title | Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer |
| title_full | Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer |
| title_fullStr | Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer |
| title_full_unstemmed | Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer |
| title_short | Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer |
| title_sort | concurrent chemo radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer |
| url | http://www.ro-journal.com/content/4/1/24 |
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