Neoadjuvant radiotherapy in the approach of locally advanced breast cancer
Open Access
- 1 January 2020
- journal article
- research article
- Published by Elsevier BV in ESMO Open
- Vol. 5 (2), e000640
- https://doi.org/10.1136/esmoopen-2019-000640
Abstract
Background Approximately 4% of European patients are diagnosed with locally advanced breast cancer (LABC), a clinical condition commonly associated with poorer prognosis. Systemic therapy is the recommended initial treatment and when inoperability criteria prevails, radiotherapy (RT) should be used for tumour downstaging. This study intends to evaluate the impact of neoadjuvant radiotherapy (NART) in the treatment of inoperable LABC. Methods A retrospective study of female patients, submitted to the NART between January 2014 and December 2018 at our institution. The evaluation of pathological response (pR) was made based on Pinder criteria. Primary endpoint: pR. Secondary endpoints: overall survival (OS) and progression-free survival (PFS). OS and PFS were calculated using the Kaplan-Meier method. Differences between groups were compared using Student’s t-test, ANOVA (Analysis of variance) and χ2 test. The statistical analyses were performed using Stata (V.13). Results A total of 76 patients were included, 18% with breast complete response. The 5 years OS was 54% and PFS was 61%. Subgroup analysis showed that pR >90% is correlated with a better OS (p=0.004). Basal-like intrinsic subtype is correlated with worse OS and PFS (p90% is correlated with a better OS. Prospective studies to explore predictive response biomarkers are necessary in order to improve patient selection and optimisation of the treatment.This publication has 24 references indexed in Scilit:
- Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trialsThe Lancet, 2011
- Preoperative concurrent paclitaxel-radiation in locally advanced breast cancer: pathologic response correlates with five-year overall survivalBreast Cancer Research and Treatment, 2010
- Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancerRadiation Oncology, 2009
- Neoadjuvant chemotherapy for locally advanced breast cancer: A review of the literature and future directionsEuropean Journal of Surgical Oncology, 2009
- Response to Neoadjuvant Therapy and Long-Term Survival in Patients With Triple-Negative Breast CancerJournal of Clinical Oncology, 2008
- Preoperative chemotherapy for women with operable breast cancerEmergencias, 2007
- Long-term results of neoadjuvant radiation therapy for breast cancerInternational Journal of Cancer, 2001
- Preoperative multimodal therapy for locally advanced non-inflammatory breast cancerClinical Oncology, 1991
- Non-metastatic locally advanced cancer of the breast treated with radiationInternational Journal of Radiation Oncology*Biology*Physics, 1984
- Radiation management of advanced breast cancerInternational Journal of Radiation Oncology*Biology*Physics, 1978