title: Efficacy of concurrent chemoradiotherapy for patients with locally recurrent or advanced inoperable breast cancer.
abstract: BACKGROUND
  This study aimed to assess the efficacy and safety of chemoradiotherapy (CRT) for locally recurrent or advanced inoperable breast cancer.
  
  
  METHODS
  Twenty patients treated between 2009 and 2013 were reviewed from a prospectively collected database. All patients had symptomatic recurrent or advanced breast cancer and had been deemed not to be ideal operative candidates. Treatment consisted of external beam radiotherapy to the primary tumor in the breast or regional lymph nodes, or both, concurrent with either capecitabine, paclitaxel, or cisplatin/etoposide chemotherapy. The grade of acute and late toxicity was evaluated, as was response to treatment, overall survival (OS), and local relapse-free survival (LRFS).
  
  
  RESULTS
  Of the 20 patients, 9 (45%) presented with primary disease and 11 (55%) had recurrent disease. A total of 11 (55%) patients had evidence of metastatic disease. The overall clinical response rate was 100%, with a clinical complete response (CR) observed in 65% of patients and a clinical partial response (PR) observed in 35% of patients. At a median follow up of 25.3 months, 2-year LRFS was 73% and 2-year OS was 80%. Local control was significantly better in patients with an initial diagnosis (hazard ratio [HR], 0.139; 95% confidence interval [CI], 0.014-0.935) and in those who had not had previous in-field radiation (HR, 0.011; 95% CI, 0.005-0.512). The only grade ≥ 3 toxicity was acute dermatologic events (30%) and late dermatologic (15%) events.
  
  
  CONCLUSIONS
  Concurrent CRT with capecitabine, paclitaxel, or cisplatin/etoposide for recurrent or advanced inoperable breast cancer is well tolerated with impressive clinical response rates and durable local control.
authors.affiliation: Department of Radiation Oncology, University of Louisville James Graham Brown Cancer Center, Louisville, KY. Electronic address: jnshau01@louisville.edu.
authors.forename: Joseph N
authors.initials: JN
authors.lastname: Shaughnessy
authors.affiliation: Department of Radiation Oncology, University of Louisville James Graham Brown Cancer Center, Louisville, KY.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Meena
authors.affiliation: Department of Radiation Oncology, University of Louisville James Graham Brown Cancer Center, Louisville, KY.
authors.forename: Neal E
authors.initials: NE
authors.lastname: Dunlap
authors.affiliation: Department of Medical Oncology, University of Louisville James Graham Brown Cancer Center, Louisville, KY.
authors.forename: Dharamvir
authors.initials: D
authors.lastname: Jain
authors.affiliation: Department of Medical Oncology, University of Louisville James Graham Brown Cancer Center, Louisville, KY.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Riley
authors.affiliation: Department of Surgical Oncology, University of Louisville James Graham Brown Cancer Center, Louisville, KY.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Quillo
authors.affiliation: Department of Radiation Oncology, University of Louisville James Graham Brown Cancer Center, Louisville, KY.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Dragun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D000069287:Capecitabine / Q000008:administration & dosage / Q000009:adverse effects; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D016879:Salvage Therapy / Q000379:methods
chemical_list: D000069287:Capecitabine; D005047:Etoposide; D017239:Paclitaxel; D002945:Cisplatin
keywords: CRT; Chemotherapy; Local disease; Radiotherapy; Unresectable