Does the Surgery-radiotherapy Interval have an Impact on Treatment Outcomes in Pre-menopausal Breast Cancer Patients Treated with Breast Conservative Surgery and Adjuvant Chemotherapy? The Shanghai Experience

2008 ◽  
Vol 72 (1) ◽  
pp. S194-S195
Author(s):  
J. Chen ◽  
X. Yu ◽  
X. Guo ◽  
Y. Feng ◽  
J. Wu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Treatment Outcomes ◽  
Cancer Patients ◽  
Conservative Surgery ◽  
Breast Cancer Patients ◽  
Breast Conservative Surgery ◽  
Impact On Treatment

Feasibility of concurrent weekly paclitaxel and radiotherapy in node-positive breast cancer: An experience from India.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 201-201
Author(s):  
Mohan Kumar ◽  
Murali Subramanian ◽  
Rajeev AG ◽  
Arul Ponni ◽  
Nirmala S ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Conservative Surgery ◽  
Weekly Paclitaxel ◽  
Adjuvant Radiation ◽  
Breast Cancer Patients ◽  
Skin Reactions ◽  
Breast Conservative Surgery ◽  
Node Positive

201 Background: Breast cancer patients with positive node and extra nodal spread are at a higher risk for distant metastases and they require immediate adjuvant chemotherapy. Similarly patients after breast conservative surgery or with patholgical T3, T4 disease require adjuvant radiation as early as possible. Taxanes have shown good response in node positive patients and are combined in many adjuvant chemotherapy regimens. Hence the current study was taken to assess the feasibility of concurrent weekly paclitaxel and radiotherapy. Methods: A prospective study was conducted on 22 female breast cancer patients after modified radical mastectomy or breast conservative surgery with pathologically positive node. Chest wall or whole breast radiotherapy was given on Tele Cobalt or Linac for a dose of 50 – 50.4Gy in conventional fractionation. Boost of 16 Gy was given to tumor cavity for those undergone breast conservative surgery. All patients received Inj. paclitaxel 60 mg/m2 once a week for 5 weeks. After completion of RT, paclitaxel dose was increased to 80mg/m2 for remaining 7 cycles. This was followed by anthracycline-based treatment sequentially as per standard adjuvant guidelines. Patients assessed weekly and toxicities graded based on CTC version 03. The minimum follow up was 2 months after completion of chemoradiation. Chi-Square test and Fisher exact test were used to interpret the results with literature. Results: See table. Skin reaction was more frequent and severe of all toxicities (p=0.003). With available literatures on adjuvant radiation alone the grade III and higher skin reactions are 3% but in our study it is 28% because of which 5/22 (22%) patients had interruption of both chemotherapy and radiation. Conclusions: Concurrent chemoradiation with weekly paclitaxel in adjuvant treatment of ca breast is associated with more Skin reactions which may result in significant treatment interruptions. It should be practiced cautiously which requires further randomized control studies to assess the toxicities in detail. [Table: see text]

Feasibility of concurrent weekly paclitaxel and radiotherapy in adjuvant treatment of breast cancer: An experience from India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11536-e11536
Author(s):  
Mohan Kumar Somashekar ◽  
Murali Subramanian V ◽  
Nirmala Srikantaiah S ◽  
Arul Ponni TR ◽  
Rajeev A G ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Conservative Surgery ◽  
Weekly Paclitaxel ◽  
Severe Toxicity ◽  
Breast Cancer Patients ◽  
Skin Reactions ◽  
Breast Conservative Surgery ◽  
Whole Breast Radiotherapy

e11536 Background: Majority of the breast cancer patients require adjuvant radiotherapy and chemotherapy for better locoregional and distant control. However the sequencing of these is still debatable . Hence concurrent chemo radiation may avoid the delay in either of the adjuvant therapies. Anthracyclines are not used concurrently with radiation because of severe toxicity. Hence the current study was taken to assess the feasibility of concurrent weekly paclitaxel and radiotherapy in adjuvant treatment of ca breast. Methods: A prospective study was conducted on 22 breast cancer patients, post modified radical mastectomy or breast conservative surgery from November 2008 to April 2010. Chest wall or whole breast radiotherapy was given on Tele Cobalt or Linac for a dose of 50 – 50.4Gy in conventional fractionation. Boost of 16 Gy was given to tumor cavity with photons or electrons for those undergone breast conservative surgery. All patients received Inj.paclitaxel 60 mg/m2 once a week for 5 weeks. After completion of RT, paclitaxel dose was increased to 80mg/m2 for remaining 7 cycles. This was followed by anthracycline based treatment sequentially as per standard adjuvant guidelines. Patients assessed weekly and toxicities graded based on CTC version 03. The minimum follow up was 2 months after completion of chemoradiation. Chi-Square test and Fisher exact test were used to interpret the results with literature. Results: See table below. Skin reaction was more frequent and severe of all toxicities (p=0.003).With available literatures on adjuvant radiation alone the grade III and higher skin reactions are 3% but in our study it is 28% because of which 5/22 (22%) patients had interruption of both chemotherapy and radiation. Conclusions: Concurrent chemoradiation with weekly paclitaxel in adjuvant treatment of ca breast is associated with more skin reactions which may result in significant treatment interruptions. It should be practiced cautiously which requires further randomized control studies to assess the toxicities in detail. [Table: see text]

Does administration of chemotherapy before radiotherapy in breast cancer patients treated with conservative surgery negatively impact local control?

1995 ◽  
Vol 13 (12) ◽  
pp. 2906-2915 ◽  
Author(s):  
C E Leonard ◽  
M E Wood ◽  
B Zhen ◽  
J Rankin ◽  
D A Waitz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Local Recurrence ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Conservative Surgery ◽  
Breast Cancer Patients ◽  
Group I ◽  
Group Ii ◽  
Prolonged Surgery

PURPOSE To determine if a delay of irradiation to the intact breast for administration of adjuvant chemotherapy results in increased local recurrence in breast cancer. PATIENTS AND METHODS The records of 262 women with 264 cases of breast cancer were reviewed. Group I contained 105 patients treated with conservative surgery, chemotherapy, and radiotherapy. Group II contained 157 patients (used as a concurrent control) treated with conservative surgery and radiotherapy only. Eighty-nine percent of subjects in group I received all chemotherapy before radiotherapy. Fifty-eight percent of patients received hormone therapy. Seventy-one percent of patients had negative surgical margins, and 74% had negative lymph nodes. For group I, conservative surgery-radiotherapy intervals in months were less than 1 (five, 5%), > or = 1 to less than 3 (10, 9%), > or = 1 to less 6 (48, 46%), and > or = 6 (42, 40%), mean of 5. For group II, the intervals were less than 1 (20, 13%), > or = 1 to less than 3 (123, 79%), > or = 3 to less than 6 (11, 7%), and > or = 6 (two, 1%), mean of 1.5. RESULTS Thirty patients (11.5%) have disease recurrence (19 distant [6%] and 12 local [5%]). There were no significant differences in local recurrence (group I, four [4%]; group II, eight [5%]; difference not significant). There were no significant differences in local recurrence in any surgery-radiotherapy interval within each group. Although we found marginal increases in the percentage of local recurrences in group I patients (with prolonged surgery-radiotherapy intervals) who had positive margins, positive lymph nodes, and tumor size more than 2 cm versus group II (without prolonged surgery-radiotherapy intervals), these results were not significant. CONCLUSION We could not identify any surgery-radiotherapy interval that resulted in increased local recurrence if radiotherapy was delayed for administration of adjuvant chemotherapy in breast cancer patients. Because of the heterogenous population of breast cancer patients, our results also support the need for further study to determine the optimum integration of radiotherapy and chemotherapy in the management of the conservatively treated breast.

Sign in / Sign up

Export Citation Format

Share Document