title: Concomitant adjuvant chemo-radiation therapy with anthracycline-based regimens in breast cancer: a single centre experience.
abstract: OBJECTIVE
  This study was done to evaluate the toxicity related to concurrent radiotherapy and anthracycline (AC)-based chemotherapy in the adjuvant treatment of early breast cancer and to investigate the impact of treatment interruptions and the feasibility of this uncommon therapeutic approach.
  
  
  METHODS
  From September 2002 to December 2007, 60 patients were treated at our Centre. The mean age at presentation was 48.5 (range 38-64) years. All patients underwent conservative surgery, and radiotherapy to the entire breast (mean dose 50 Gy; range 46-52 Gy). AC-based regimens consisted of four cycles of AC (doxorubicin plus cyclophosphamide) or four cycles of epirubicin (EPI) followed by four courses of cyclophosphamide, methotrexate and 5-fluorouracil (CMF).
  
  
  RESULTS
  Concomitant treatment caused acute skin G3 toxicity in 8.9% of patients and one case of G4 toxicity (1.7%). Concerning cardiac assessment, six of the 56 evaluable patients (10.7%) developed an asymptomatic decline of left ventricular ejection fraction >10% and <20% of the baseline value. Radiotherapy was temporarily stopped in 21.3% and chemotherapy in 57.1% of patients.
  
  
  CONCLUSIONS
  In our experience, concomitant chemotherapy did not emerge as a significant factor in radiotherapy interruption. Moreover, no severe cardiac events were recorded.
authors.affiliation: Radiotherapy Unit, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Livi
authors.forename: I
authors.initials: I
authors.lastname: Meattini
authors.forename: V
authors.initials: V
authors.lastname: Scotti
authors.forename: C
authors.initials: C
authors.lastname: Saieva
authors.forename: G
authors.initials: G
authors.lastname: Simontacchi
authors.forename: L
authors.initials: L
authors.lastname: Marrazzo
authors.forename: C
authors.initials: C
authors.lastname: Franzese
authors.forename: S
authors.initials: S
authors.lastname: Cassani
authors.forename: F
authors.initials: F
authors.lastname: Paiar
authors.forename: V
authors.initials: V
authors.lastname: Di Cataldo
authors.forename: J
authors.initials: J
authors.lastname: Nori
authors.forename: L
authors.initials: L
authors.lastname: Jose Sanchez
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: L
authors.initials: L
authors.lastname: Cataliotti
authors.forename: G
authors.initials: G
authors.lastname: Biti
mesh_terms: D000328:Adult; D018943:Anthracyclines / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D055088:Early Detection of Cancer; D015251:Epirubicin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines; D015251:Epirubicin; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate