scholarly journals Efficacy of Combination Neoadjuvant Chemotherapy and Regional Inductive Moderate Hyperthermia in the Treatment of Patients With Locally Advanced Breast Cancer

2020 ◽  
Vol 19 ◽  
pp. 153303382096359
Author(s):  
Anton Loboda ◽  
Ivan Smolanka Sr ◽  
Valerii E. Orel ◽  
Liubov Syvak ◽  
Tetiana Golovko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Objective Response ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Control Group ◽  
Axillary Lymph ◽  
Experimental Group

Purpose: To evaluate the efficacy of neoadjuvant chemotherapy in combination with regional inductive moderate hyperthermia for patients with locally advanced breast cancer. Patients and Methods: 200 patients with stage IIB-IIIA breast cancer received neoadjuvant chemotherapy (control group, n = 97) or chemotherapy combined with hyperthermia (experimental group, n = 103). Inductive hyperthermia was set at 27.12 ± 0.16 MHz and the 50 W output power. Results: Thermal and color Doppler ultrasound imaging demonstrated that hyperthermia increased the surface temperature on the breasts to < 4°С while the mean values for systolic blood flow were 3.5 times as high as those prior to treatment. Assessment of tumor size and response found a (31.24 ± 3.85)% reduction in the size of the primary tumor in patients receiving chemotherapy + hyperthermia, while chemotherapy alone showed a (22.95 ± 3.61)% decrease on average (p = 0.034). The rate of objective response increased by 15.9% in the experimental group (р = 0.034) compared with the control group. The patients in the experimental group also had axillary lymph node regression of 14.17% greater than in the control group (p = 0.011). Moreover, the combination treatment allowed to increase the proportion of women eligible for breast-conserving and reconstructive surgery by 13.63% in the experimental group. The viable tumor volume was lower in patients receiving neoadjuvant chemotherapy + hyperthermia (24.4 ± 0.2)% compared with those given chemotherapy alone (30.4 ± 0.25)%. The 10-year overall survival rates were higher (log-rank: p = 0.009) in breast cancer patients who underwent chemotherapy combined with hyperthermia than in patients receiving chemotherapy only. Conclusion: The combination neoadjuvant chemotherapy and the technology of regional inductive moderate hyperthermia improved the efficacy of treatment for patients with locally advanced breast cancer staged IIB-IIIA.

Serum Levels of Tumor Necrosis Factor Alpha Correlate with Response to Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

2004 ◽  
Vol 19 (2) ◽  
pp. 130-134 ◽  
Author(s):  
U. Berberoglu ◽  
E. Yildirim ◽  
O. Celen
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Serum Levels ◽  
Advanced Breast ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Tnf Α

It has been shown that serum levels of tumor necrosis factor alpha (TNF-α) are increased in breast cancer patients. There are few data available on the reduction of serum levels of this cytokine following chemotherapy. The aim of this study was to determine the effect of neoadjuvant chemotherapy on serum concentrations of TNF-α and the relation to response rates in locally advanced breast cancer. Twenty consecutive patients with non-inflammatory stage III-B breast cancer achieving a partial or complete clinical response to three courses of neoadjuvant chemotherapy followed by modified radical mastectomy were prospectively included in the study and evaluated. Sera were collected before the start and after the termination of chemotherapy. Serum concentrations of TNF-α were measured by an ELISA method. The pathological response rates were also evaluated and recorded. The control group consisted of 12 healthy age-matched women. The mean pre-treatment TNF-α value of breast cancer patients was 15.9±0.9 pg/mL while it was 5.8±1.7 pg/mL in the control group; the difference was statistically significant (p<0.0001). The serum levels of TNF-α were markedly decreased in patients with partial and complete responses compared to pre-treatment values (p<0.0001). There was also a difference in TNF-α levels in patients with partial vs complete responses (p<0.0001). The relative change between pre- and post-treatment values correlated significantly with the type of response (p=0.004). These results suggest that the serum concentration of TNF-α can be an indicator of response and could be used in clinical decision-making for patients with locally advanced breast cancer.

scholarly journals A clinical study of outcome of neoadjuvant chemotherapy in 30 cases of locally advanced breast carcinoma

2019 ◽  
Vol 6 (12) ◽  
pp. 4383
Author(s):  
Shwetal Ravindrabhai Sonvane ◽  
Mukesh Pancholi ◽  
Akhil Sharma
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Clinical Response ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Axillary Lymph ◽  
Management Problem

Background: Locally advanced breast cancer presents with a difficult management problem. It remains a challenge to achieve local and distant control of locally advanced breast cancer. Over the last decade preoperative/ neoadjuvant chemotherapy has emerged as the standard of care for these patients. Successful reduction in the size of the tumor is associated with increased rate of operability. The objective of this study is to observe the response of neoadjuvant chemotherapy in locally advanced breast carcinoma in form of outcome and complications. The outcome is measured as down staging or downgrading of tumor, results of surgery and its complications, disease free survival and recurrence.Methods: This is the observational prospective study of consecutive 30 cases of locally advanced breast cancer admitted in department of general surgery during a period from May 2017 to August 2018 at new civil hospital, Surat. Neo adjuvant chemotherapy were given every three weekly and the response of therapy calculated in form of reduction in the size of tumor or getting the margin free from skin or pectoral muscles or reduction in the axillary lymph node mass.Results: In this study about 93% of cases responded to neoadjuvant chemotherapy with 10% of cases shows complete clinical response where tumor becomes completely free from skin or pectoral muscles or negative axillary lymph nodes.Conclusions: With the evidence from the literature and study conducted earlier, our observations of clinical response of neoadjuvant chemotherapy in patients with locally advanced breast cancer had corroborative evidence.

Expression of stathmin in tumor to predict response to neoadjuvant chemotherapy with docetaxel-containing regimens in locally advanced breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11566-e11566
Author(s):  
Xuli Meng
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Univariate Analysis ◽  
Objective Response ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Gene Assay ◽  
Response To Neoadjuvant Chemotherapy

e11566 Background: We performed this retrospective study to evaluate the value of clinicopathological factors and a novel molecular marker stathmin in predicting treatment response to neoadjuvant chemotherapy (NCT) with docetaxel-containing regimens in patients with locally advanced breast cancer. Methods: Fifty-four consecutive locally advanced patients receiving docetaxel-containing NCT between January 2006 and July 2010 in Zhejiang Cancer Hospital were included. The expression levels of estrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor-2 (HER-2), and p53 were detected by immunohistochemistry, while expression of stathmin mRNA was measured by Quanti-Gene assay. Results: The overall clinical objective response (cOR) rate was 75.9% (41/54) in breast. A total of 34 patients (63.0%) experienced pathological OR (pOR), with pathological complete remission (pCR) rate of 20.4% (11/54) in breast and 16.7% (9/54) in both breast and axilla. In univariate analysis, there were associations of pOR in both breast and axilla with age (P=0.054), ER status (P=0.059), subtypes (P=0.062), p53 (P=0.030), and stathmin expression (three terciles) (P=0.039). Mean expression of stathmin in pOR group was 0.410, compared with that in no response group of 0.556 (P=0.051 by Student’s t-test). Similarly, a lower expression of stathmin might represent a higher pCR rate (P=0.061). Moreover, the LOWESS smoothing plot showed the same trend, i.e., that tumor with a lower level of stathmin expression had a higher probability of response to docetaxel-containing NCT. After multivariate adjustment, both ER and stathmin kept being significant with hazard ratio of 4.58 (95% CI: 1.11-18.94, P=0.036) and 2.94 (95% CI: 1.26-6.86, P=0.012), respectively. Conclusions: ER and stathmin were independent predictive factors for NCT with docetaxel-containing regimens.

scholarly journals Neoadjuvant chemotherapy in combination with surgery in the treatment of local advanced breast cancer

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Haixia Zhao ◽  
Jinying Zhang ◽  
Yanxia Lu ◽  
Jihai Jin
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Radical Resection ◽  
Advanced Breast ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference

Objective: To investigate the effect of neoadjuvant chemotherapy combined with surgery on locally advanced breast cancer and its prognosis. Methods: One hundred and fifty-four patients with locally advanced breast cancer who were admitted to our hospital from February 2014 to April 2015 were selected as the study subjects. They were divided into an observation group and a control group according to the principle of random equalization, 77 each group. The observation group was treated with TAC scheme, neoadjuvant chemotherapy combined with modified radical resection, and continuously treated with the same scheme after operation until the end of the course of treatment. The control group was treated with modified radical resection and TAC scheme. The clinical efficacy of the two groups was observed, and the perioperative indications, prognosis and occurrence of adverse reactions were compared between the two groups. Results: The total effective rate of the observation group was 76.62%, significantly higher than that of the control group (55.84%, P<0.05). The observation group had shorter operation time and hospitalization time and less bleeding amount compared to the control group (P<0.05). The metastasis rate and recurrence rate of the observation group were significantly lower than those of the control group (P<0.05); there was a significant difference between the two groups (P<0.05). The one-year and three-year survival rates of the observation group were significantly higher than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups after operation (P>0.05). Conclusion: Preoperative neoadjuvant chemotherapy in combination with TAC scheme can reduce the difficulty of operation, improve the curative effect of patients, significantly improve the prognosis of patients and prolong the survival time, which is worth clinical application. doi: https://doi.org/10.12669/pjms.35.5.310 How to cite this:Zhao H, Zhang J, Lu Y, Jin J. Neoadjuvant chemotherapy in combination with surgery in the treatment of local advanced breast cancer. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.310 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Pathological responses and survival outcomes in patients with locally advanced breast cancer after neoadjuvant chemotherapy: a single-institute experience

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Kyrillus S. Shohdy ◽  
Doaa S. Almeldin ◽  
Madonna A. Fekry ◽  
Mahmoud A. Ismail ◽  
Nedal A. AboElmaaref ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Objective Response ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Advanced Breast ◽  
Survival Outcomes ◽  
Ki 67

Abstract Background Pathological complete response (pCR) is a surrogate for the efficacy of neoadjuvant chemotherapy (NCT) in locally advanced breast cancer (LABC). We analyzed the predictive clinical factors for pathological responses and survival outcomes in a cohort of Egyptian patients. Methods We evaluated the medical records of patients with breast cancer who received NCT in our academic institute. Survival curves were estimated with the Kaplan-Meier method. Cox proportional models were used for multiple regression analysis. Results Our cohort included 368 patients with a median age of 48 years (range 21–70). The median follow-up time was 3 years. The clinical tumor stage (T3–4) represented 58%, with 80% having positive axillary nodes. The luminal subgroup prevailed by 68%. The objective response rate (ORR) reached 78%, and 16% of patients achieved pCR. The clinical node stage and optimal chemotherapy were associated with higher ORR (p = 0.035 and p = 0.001, respectively). Predictors of pCR were clinical T-stage (p = 0.026), high Ki-67 index > 20 (p = 0.05), and receiving optimal chemotherapy (p = 0.014). The estimated 3-year disease free-survival (DFS) was 53%. Receptor status, achieving ORR, and pCR were associated with better DFS with hazard ratios of 0.56, p = 0.008; 0.38, p = 0.04; and 0.28, p = 0.007, respectively. Conclusions Luminal tumors still draw benefit from neoadjuvant chemotherapy in terms of clinical response and breast conservative surgery. Treatment escalation to those who did not achieve pCR requires more investigation, given a higher recurrence rate in real-world experience.

Sign in / Sign up

Export Citation Format

Share Document