Remission rates in breast cancer treated with preoperative chemotherapy and radiotherapy.
OBJECTIVE
Evaluation of remission rates after neoadjuvant chemotherapy alone or followed by preoperative radiotherapy.


METHODS
194 women with 198 biopsy-proven breast tumors were evaluated in this retrospective study. Of the 198 cases evaluated, 64 received neoadjuvant chemotherapy followed by surgery and adjuvant irradiation (CT group). In 134 cases, sequential preoperative chemo-/radiotherapy (CT-RT group) was given. In both groups, endocrine treatment was initiated in case of positive hormone receptor status after chemotherapy. The whole breast was homogeneously irradiated using 2-Gy fractions up to a total dose of 50 Gy, followed by a boost of 6-11 Gy to the tumor.


RESULTS
A histologically proven complete remission (pCR) was achieved in 3% (2/64) in the CT and in 42% (56/134) in the CTRT group. The logistic regression analysis, including clinical tumor category (cT), lymph node (cN) and metastasis status (cM), grading (G), hormone receptor status (HRS), number of preoperative chemotherapy cycles, preoperative tumor volume, and preoperative radiotherapy, revealed that HRS (p = 0.0232) and radiotherapy (p < 0.0001) were significant factors for achieving pCR.


CONCLUSIONS
Combination of neoadjuvant chemo-/radiotherapy results in significantly higher rates of complete remission than neoadjuvant chemotherapy alone. The significance for tumor-free and overall survival has to be evaluated.
Gerlach
Bärbel
B
Department of Radiation Oncology, University Clinic Düsseldorf, Germany. Gerlach@med.uni-duesseldorf.de
Audretsch
Werner
W
Gogolin
Frank
F
Königshausen
Theodor
T
Rohn
Ralf
R
Schmitt
Gerd
G
Dimmerling
Peter
P
Gripp
Stephan
S
Hartmann
Karl Axel
KA
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016015:Logistic Models; D015411:Mastectomy, Modified Radical; D015412:Mastectomy, Segmental; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011300:Preoperative Care; D011879:Radiotherapy Dosage; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors
D003037:Cobalt Radioisotopes