A phase III randomized study on the sequencing of radiotherapy and chemotherapy in the conservative management of early-stage breast cancer

Arcangeli, Giorgio; Pinnaro, Paola; Rambone, Rita; Giannarelli, Diana; Benassi, Marcello

doi:10.1016/J.IJROBP.2005.0

Title: A phase III randomized study on the sequencing of radiotherapy and chemotherapy in the conservative management of early-stage breast cancer

Full Record
Other Related Research

Abstract

Purpose: To compare two different timings of radiation treatment in patients with breast cancer who underwent conservative surgery and were candidates to receive adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy. Methods and Materials: A total of 206 patients who had quadrantectomy and axillary dissection for breast cancer and were planned to receive adjuvant CMF chemotherapy were randomized to concurrent or sequential radiotherapy. Radiotherapy was delivered only to the whole breast through tangential fields to a dose of 50 Gy in 20 fractions over 4 weeks, followed by an electron boost of 10-15 Gy in 4-6 fractions to the tumor bed. Results: No differences in 5-year breast recurrence-free, metastasis-free, disease-free, and overall survival were observed in the two treatment groups. All patients completed the planned radiotherapy. No evidence of an increased risk of toxicity was observed between the two arms. No difference in radiotherapy and in the chemotherapy dose intensity was observed in the two groups. Conclusions: In patients with negative surgical margins receiving adjuvant chemotherapy, radiotherapy can be delayed to up to 7 months. Concurrent administration of CMF chemotherapy and radiotherapy is safe and might be reserved for patients at high risk of local recurrence, such as those with positivemore »« less

Authors:

Arcangeli, Giorgio ^[1]; Pinnaro, Paola ^[1]; Rambone, Rita ^[1]; Giannarelli, Diana ^[1]; Benassi, Marcello ^[1]

Regina Elena National Cancer Institute, Rome (Italy)

Publication Date:: Sun Jan 01 00:00:00 EST 2006

OSTI Identifier:: 20788280

Resource Type:: Journal Article

Journal Name:: International Journal of Radiation Oncology, Biology and Physics

Additional Journal Information:: Journal Volume: 64; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2005.06.040; PII: S0360-3016(05)02224-8; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; ELECTRONS; ENDOXAN; MAMMARY GLANDS; METASTASES; METHOTREXATE; PATIENTS; RADIOTHERAPY; SURGERY; TOXICITY

Citation Formats


                    Arcangeli, Giorgio, Pinnaro, Paola, Rambone, Rita, Giannarelli, Diana, and Benassi, Marcello. A phase III randomized study on the sequencing of radiotherapy and chemotherapy in the conservative management of early-stage breast cancer.  United States: N. p., 2006. 
        Web.  doi:10.1016/J.IJROBP.2005.0.

Copy to clipboard


                    Arcangeli, Giorgio, Pinnaro, Paola, Rambone, Rita, Giannarelli, Diana, & Benassi, Marcello. A phase III randomized study on the sequencing of radiotherapy and chemotherapy in the conservative management of early-stage breast cancer.  United States.  https://doi.org/10.1016/J.IJROBP.2005.0

Copy to clipboard


                    Arcangeli, Giorgio, Pinnaro, Paola, Rambone, Rita, Giannarelli, Diana, and Benassi, Marcello. 2006.  
        "A phase III randomized study on the sequencing of radiotherapy and chemotherapy in the conservative management of early-stage breast cancer".  United States.  https://doi.org/10.1016/J.IJROBP.2005.0.

Copy to clipboard


                    
@article{osti_20788280,

  title        = {A phase III randomized study on the sequencing of radiotherapy and chemotherapy in the conservative management of early-stage breast cancer},

  author       = {Arcangeli, Giorgio and Pinnaro, Paola and Rambone, Rita and Giannarelli, Diana and Benassi, Marcello},

  abstractNote = {Purpose: To compare two different timings of radiation treatment in patients with breast cancer who underwent conservative surgery and were candidates to receive adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy. Methods and Materials: A total of 206 patients who had quadrantectomy and axillary dissection for breast cancer and were planned to receive adjuvant CMF chemotherapy were randomized to concurrent or sequential radiotherapy. Radiotherapy was delivered only to the whole breast through tangential fields to a dose of 50 Gy in 20 fractions over 4 weeks, followed by an electron boost of 10-15 Gy in 4-6 fractions to the tumor bed. Results: No differences in 5-year breast recurrence-free, metastasis-free, disease-free, and overall survival were observed in the two treatment groups. All patients completed the planned radiotherapy. No evidence of an increased risk of toxicity was observed between the two arms. No difference in radiotherapy and in the chemotherapy dose intensity was observed in the two groups. Conclusions: In patients with negative surgical margins receiving adjuvant chemotherapy, radiotherapy can be delayed to up to 7 months. Concurrent administration of CMF chemotherapy and radiotherapy is safe and might be reserved for patients at high risk of local recurrence, such as those with positive surgical margins or larger tumor diameters.},

  doi          = {10.1016/J.IJROBP.2005.0},

  url          = {https://www.osti.gov/biblio/20788280},
  journal      = {International Journal of Radiation Oncology, Biology and Physics},

  issn         = {0360-3016},

  number       = 1,

  volume       = 64,

  place        = {United States},

  year         = {Sun Jan 01 00:00:00 EST 2006},

  month        = {Sun Jan 01 00:00:00 EST 2006}

}

Copy to clipboard

Journal Article:

https://doi.org/10.1016/J.IJROBP.2005.0

Other availability

Find in Google Scholar

Search WorldCat to find libraries that may hold this journal

Save / Share:

Export Metadata

Save to My Library

Similar records in OSTI.GOV collections:

Concurrent Cyclophosphamide, Methotrexate, and 5-Fluorouracil Chemotherapy and Radiotherapy for Early Breast Carcinoma

Journal Article Livi, Lorenzo; Saieva, Calogero; Borghesi, Simona; ... - International Journal of Radiation Oncology, Biology and Physics

Purpose: The optimal sequencing of adjuvant chemotherapy (CT) and radiation therapy (RT) in patients with early-stage breast cancer remains unclear. Patients and Methods: We retrospectively compared 485 patients treated with conservative breast surgery and postoperative whole-breast RT and six courses of CMF (cyclophosphamide 600 mg/m{sup 2}, methotrexate 40 mg/m{sup 2}, and 5-fluorouracil 600 mg/m{sup 2}) with 300 patients who received postoperative CMF only and with 509 patients treated with postoperative whole-breast RT only. The mean radiation dose delivered was 50 Gy (range, 46-52 Gy) with standard fractionation. The boost dose was 6-16 Gy according to resection margins and at themore »« less
https://doi.org/10.1016/j.ijrobp.2007.10.042
Preoperative hyperfractionated chemoradiation for locally recurrent rectal cancer in patients previously irradiated to the pelvis: A multicentric phase II study

Journal Article Valentini, Vincenzo; Morganti, Alessio; Gambacorta, M; ... - International Journal of Radiation Oncology, Biology and Physics

Purpose: The combination of irradiation and total mesorectal excision for rectal carcinoma has significantly lowered the incidence of local recurrence. However, a new problem is represented by the patient with locally recurrent cancer who has received previous irradiation to the pelvis. In these patients, local recurrence is very often not easily resectable and reirradiation is expected to be associated with a high risk of late toxicity. The aim of this multicenter phase II study is to evaluate the response rate, resectability rate, local control, and treatment-related toxicity of preoperative hyperfractionated chemoradiation for locally recurrent rectal cancer in patients previously irradiatedmore »« less
https://doi.org/10.1016/J.IJROBP.2005.0
Adjuvant chemo- and hormonal therapy in locally advanced breast cancer: a randomized clinical study

Journal Article Schaake-Koning, C; van der Linden, E; Hart, G; ... - Int. J. Radiat. Oncol., Biol. Phys.; (United States)

Between 1977 and 1980, 118 breast cancer patients with locally advanced disease, T3B-4, any N, M0 or T1-3, tumor positive axillary apex biopsy, were randomized to one of three arms: I: radiotherapy (RT) to the breast and adjacent lymph node areas; II: RT followed by 12 cycles of cyclophosphamide, methotrexate, 5 fluorouracil (CMF) and tamoxifen during the chemotherapy period; III: 2 cycles of adriamycin and vincristine (AV), alternated with 2 cycles of CMF, then RT, followed by another 4 cycles of AV, alternated with 4 CMF; tamoxifen during the entire treatment period. The median follow-up period was 5 1/2 years.more »« less
https://doi.org/10.1016/0360-3016(85)90028-8
A phase III randomized trial comparing adjuvant concomitant chemoradiotherapy versus standard adjuvant chemotherapy followed by radiotherapy in operable node-positive breast cancer: Final results

Journal Article Rouesse, Jacques; Lande, Brigitte; Bertheault-Cvitkovic, Frederique; ... - International Journal of Radiation Oncology, Biology and Physics

Purpose: To compare concomitant and sequential adjuvant chemoradiotherapy regimens in node-positive, operable breast cancer patients. Methods and Materials: This was a randomized, French, multicenter, phase III trial enrolling 638 eligible women with prior breast surgery and positive axillary dissection. Patients in Arm A received 500 mg/m{sup 2} 5-fluorouracil, 12 mg/m{sup 2} mitoxantrone, and 500 mg/m{sup 2} cyclophosphamide, with concomitant radiotherapy (50 Gy {+-} 10-20-Gy boost). Patients in Arm B received 500 mg/m{sup 2} 5-fluorouracil, 60 mg/m{sup 2} epirubicin, and 500 mg/m{sup 2} cyclophosphamide, with subsequent radiotherapy. Chemotherapy was administered on Day 1 every 21 days for 4 cycles. Results: Medianmore »« less
https://doi.org/10.1016/J.IJROBP.2005.1
The effect of postoperative radiotherapy on the feasibility of optimal dose adjuvant CMF chemotheraphy in stage II breast carcinoma

Journal Article Sulkes, A; Brufman, G; Rizel, S; ... - Int. J. Radiat. Oncol., Biol. Phys.; (United States)

The impact of a number of variables upon the effectiveness of adjuvant chemotherapy given to 87 patients with Stage II breast carcinoma was retrospectively analyzed. Adjuvant chemotherapy consisted of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). Drugs were given in optimal doses (85% or more of the planned dose) to 17% of the patients; in intermediate doses (66 to 84% of the planned dose) to 50% of the patients; and in low doses (65% or less of the planned dose) to 33% of the patients. Myelosuppression was the main reason for giving intermediate or low doses. At a median follow-up of threemore »« less
https://doi.org/10.1016/0360-3016(83)90202-X

Similar Records