title: Preoperative radio-chemotherapy in early breast cancer patients: long-term results of a phase II trial.
abstract: OBJECTIVE
  This phase II trial aimed to investigate the efficacy of concurrent radio- (RT) and chemotherapy (CT) in the preoperative setting for operable, non-metastatic breast cancer (BC) not amenable to initial breast-conserving surgery (BCS).
  
  
  METHODS
  From 2001 to 2003, 59 women were included. CT consisted of four cycles of 5-FU, 500 mg/m(2)/d, continuous infusion (d1-d5) and vinorelbine, 25 mg/m(2) (d1 and d6). Starting concurrently with the second cycle, RT delivered 50 Gy to the breast and 46 Gy to the internal mammary and supra/infra-clavicular areas. Breast surgery and lymph node dissection were then performed. Adjuvant treatment consisted of a 16 Gy boost to the tumor bed after BCS, FEC (four cycles of fluorouracil 500 mg/m(2), cyclophosphamide 500 mg/m(2), and epirubicin 100 mg/m(2), d1; d21) for pN1-3 and hormone-therapy for positive hormone receptors BC.
  
  
  RESULTS
  The in-breast pathological complete response rate was 27%. BCS was performed in 41 (69%) pts. Overall and distant-disease free survivals at 5 years were respectively 88% [95% CI 80-98] and 83% [95% CI 74-93] whereas locoregional and local controls were 90% [95% CI 82-97] and 97% [95% CI 92-100]. Late toxicity (CTCAE-V3) was assessed in 51 pts (86%) with a median follow-up of 7 years [5-8]. Four (8%) experienced at least one grade III toxicities (one telangectasia and three fibroses). Cosmetic results, assessed in 35 of the 41 pts (85%) who retained their breasts, were poor in four pts (11%).
  
  
  CONCLUSIONS
  Preoperative concurrent administration of RT and CT is an effective regimen. Long-term toxicity is moderate. This association deserves further evaluations in prospective trials.
authors: Department of Radiation Oncology, Institut Curie, Paris, France.
authors: Marc A
authors: MA
authors: Bollet
authors: Lisa
authors: L
authors: Belin
authors: Fabien
authors: F
authors: Reyal
authors: François
authors: F
authors: Campana
authors: Rémi
authors: R
authors: Dendale
authors: Youlia M
authors: YM
authors: Kirova
authors: Fabienne
authors: F
authors: Thibault
authors: Véronique
authors: V
authors: Diéras
authors: Brigitte
authors: B
authors: Sigal-Zafrani
authors: Alain
authors: A
authors: Fourquet
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D015251:Epirubicin; D014747:Vinblastine; D003520:Cyclophosphamide; D000077235:Vinorelbine; D005472:Fluorouracil