title: Feasibility of concurrent adjuvant chemotherapy and radiotherapy after breast-conserving surgery in early breast cancer.
abstract: BACKGROUND
  The optimal sequence of chemotherapy (CT) and radiotherapy (RT) remains uncertain after breast-conserving surgery (BCS). The current study was performed to evaluate whether the concurrent RT with CT increases the toxicities.
  
  
  METHODS
  Two hundred and thirty-eight patients with stages I and II breast cancers were prospectively allocated to concurrent CT and RT (n = 133) and sequential CT and RT (n = 105) after BCS. In the sequential group, RT was started after the completion of three cycles of CT and additional three cycles of CT were delivered after RT.
  
  
  RESULTS
  There was no significant difference in Grade 3 or 4 hematologic toxicities during CT between the two groups. Radiation related adverse effects were not different between the two groups. During the median follow-up period of 42 months (range: 16-60 months), 18 patients (13.5%) of the concurrent group had systemic recurrence of breast cancer, whereas 20 patients (19.1%) of the sequential group had systemic recurrence. Disease-free survival and local recurrence were not different between the two groups.
  
  
  CONCLUSIONS
  Concurrent CT and RT were not associated with increased toxicity and showed reasonable cosmetic results. The current study indicates that concurrent RT and CT after BCS is a feasible treatment modality with an advantage of shortening the treatment time.
authors.affiliation: Department of Surgery, Inje University Sanggye Paik Hospital, Seoul, South Korea. shwhan@unitel.co.kr
authors.forename: Sehwan
authors.initials: S
authors.lastname: Han
authors.forename: Juree
authors.initials: J
authors.lastname: Kim
authors.forename: Seungchang
authors.initials: S
authors.lastname: Sohn
authors.forename: Geum-Hee
authors.initials: GH
authors.lastname: Kwak
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Kyeongmee
authors.initials: K
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D015412:Mastectomy, Segmental; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant
chemical_list: D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate