title: Pathological response to preoperative concurrent chemo-radiotherapy for breast cancer: results of a phase II study.
abstract: 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.
authors.affiliation: Department of Radiotherapy, Institut Curie, 26 Rue d'Ulm, 75005 Paris, France. marc.bollet@curie.net
authors.forename: Marc A
authors.initials: MA
authors.lastname: Bollet
authors.forename: Brigitte
authors.initials: B
authors.lastname: Sigal-Zafrani
authors.forename: Laetitia
authors.initials: L
authors.lastname: Gambotti
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Extra
authors.forename: Martine
authors.initials: M
authors.lastname: Meunier
authors.forename: Claude
authors.initials: C
authors.lastname: Nos
authors.forename: Rémi
authors.initials: R
authors.lastname: Dendale
authors.forename: François
authors.initials: F
authors.lastname: Campana
authors.forename: Youlia M
authors.initials: YM
authors.lastname: Kirova
authors.forename: Véronique
authors.initials: V
authors.lastname: Diéras
authors.forename: Alain
authors.initials: A
authors.lastname: Fourquet
mesh_terms: 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
chemical_list: D014747:Vinblastine; D000077235:Vinorelbine; D005472:Fluorouracil