Prospective multicenter study of combined treatment with chemotherapy and radiotherapy in breast cancer women with the rare clinical scenario of ipsilateral supraclavicular node recurrence without distant metastases.
OBJECTIVE
To evaluate the role of chemotherapy combined with curative radiotherapy in breast cancer patients who presented with recurrent ipsilateral supraclavicular lymph node metastases (ISLM) without "nonregional disease," we designed an observational study performed prospectively.


METHODS
Forty-four consecutive patients with ISLM from breast cancer as part of recurrent regional disease without distant metastases were included in this study. All patients received chemotherapy with doxorubicin-based schema or paclitaxel for six courses and curative radiotherapy (60 Gy/30 fractions of 2 Gy/5 days a week). An "involved field" radiation was delivered during the interval between the third and fourth chemotherapy course; hormonal therapy was given based on receptor status.


RESULTS
The rate of overall clinical response after chemotherapy and radiotherapy was 94.9%. Median time to progression and overall survival were 28 and 40 months, respectively; the 5-year actuarial overall survival and disease-free survival rates were 35% (95% confidence interval, 19-51) and 20% (95% confidence interval, 6-34), respectively.


CONCLUSIONS
A curative course of intravenous chemotherapy and radical irradiation is feasible in patients with ISLM. All patients presenting recurrence in supraclavicular nodes should be treated with definitive locoregional treatments and systemic therapy because the outcomes are better than might be historically assumed.
Pergolizzi
Stefano
S
Department of Radiological Science, University of Messina, Messina, Italy. Stefano.Pergolizzi@unime.it
Adamo
Vincenzo
V
Russi
Elvio
E
Santacaterina
Anna
A
Maisano
Roberto
R
Numico
Gianmauro
G
Palazzolo
Carmela
C
Ferraù
Francesco
F
Settineri
Nicola
N
Altavilla
Giuseppe
G
Girlando
Andrea
A
Spadaro
Pietro
P
Cascinu
Stefano
S
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002968:Clavicle; D003131:Combined Modality Therapy / Q000379:methods; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000532:radiotherapy*; D009367:Neoplasm Staging / Q000379:methods; D017239:Paclitaxel / Q000008:administration & dosage; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D016019:Survival Analysis
D004317:Doxorubicin; D003520:Cyclophosphamide; D017239:Paclitaxel; D005472:Fluorouracil