Pathological response to preoperative concurrent chemo-radiotherapy for breast cancer: results of a phase II study.
This study evaluated, in terms of pathological complete response (pCR) and acute toxicity, preoperative concurrent (5-fluorouracil (5-FU)-vinorelbine) chemoradiotherapy for large breast cancers. A total of 60 women were included in the study. Chemotherapy consisted of 4 cycles of 5-FU, 500 mg/m2/d, continuous infusion (d1-d5) and vinorelbine, 25 mg/m2 (d1; d6). Starting with the second cycle, radiotherapy delivered 50 Gy to the breast and 46 Gy to the internal mammary and supra/infra-clavicular lymph nodes. Breast surgery and axillary lymph node dissection were then performed. Four patients did not complete their chemotherapy. Breast conservation was possible in 69% of patients. The rate of pCR was 27%. Three factors were associated with pCR: histological grade 3, absence of hormonal receptors and high mitotic index. Grade 4 haematological toxicity occurred in 22% of patients. In conclusion, chemoradiotherapy demonstrated good efficacy, both in terms of pCR and in allowing breast conservation with acceptable tolerance.
Bollet
Marc A
MA
Department of Radiotherapy, Institut Curie, 26 Rue d'Ulm, 75005 Paris, France. marc.bollet@curie.net
Sigal-Zafrani
Brigitte
B
Gambotti
Laetitia
L
Extra
Jean-Marc
JM
Meunier
Martine
M
Nos
Claude
C
Dendale
Rémi
R
Campana
François
F
Kirova
Youlia M
YM
Diéras
Véronique
V
Fourquet
Alain
A
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis / Q000473:pathology; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D008938:Mitosis; D011300:Preoperative Care / Q000379:methods; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
D014747:Vinblastine; D000077235:Vinorelbine; D005472:Fluorouracil