In patients with a de novo diagnosis of breast cancer with synchronous distant metastases , surgery and radiotherapy result in considerably better locoregional tumor control .
An improvement in survival has not been consistently proven , but may exist in subgroups of patients .
Bei Patientinnen mit primärer Fernmetastasierung führt die lokale Beh and lung mittels Operation und/oder Strahlentherapie zur besseren lokalen Tumorkontrolle .
Aim The purpose of this work is to give practical guidelines for radiotherapy of locally advanced , inflammatory and metastatic breast cancer at first presentation .
ZusammenfassungZielZiel der Arbeit ist die Entwicklung von Praxis-Leitlinien zur Strahlentherapie des lokal fortgeschrittenen einschließlich des inflammatorischen Mammakarzinoms sowie zur lokalen Therapie bei synchroner Fernmetastasierung .
Ein Überlebensvorteil besteht wohl nicht , möglicherweise aber doch für einige Subgruppen der Patientinnen .
Preoperative concurrent paclitaxel-radiation in locally advanced breast cancer: pathologic response correlates with five-year overall survival
We have previously demonstrated high pathologic response rates after neoadjuvant concurrent chemoradiation in patients with locally advanced breast cancer ( LABC ) . We now report disease-free survival ( DFS ) and overall survival ( OS ) in the context of pathologic response . 105 LABC patients ( White 46 % , Non-White 54 % ) were treated with paclitaxel ( 30 mg/m2 intravenously twice a week ) for 10–12 weeks . Daily radiotherapy was delivered to breast , axillary , and supraclavicular lymph nodes during weeks 2–7 of paclitaxel treatment , at 1.8 Gy per fraction to a total dose of 45 Gy with a tumor boost of 14 Gy at 2 Gy/fraction . Pathological complete response ( pCR ) was defined as the absence of invasive cancer in breast and lymph nodes and pathological partial response ( pPR ) as the persistence of < 10 microscopic foci of invasive carcinoma in breast or lymph nodes . Pathologic response ( pCR and pPR ) after neoadjuvant chemoradiation was achieved in 36/105 patients ( 34 % ) and was associated with significantly better DFS and OS . Pathological responders had a lower risk of recurrence or death ( HR = 0.35 , P = 0.01 ) and a longer OS ( HR = 4.27 , P = 0.01 ) compared with non-responders . Median DFS and OS were 57 and 84 months for non-responders , respectively , and have not yet been reached for responders . Importantly , pathologic response was achieved in 54 % of patients with HR negative tumors ( 26/48 ) . In conclusion , pathologic response to concurrent paclitaxel-radiation translated into superior DFS and OS . Half of the patients with HR negative tumors achieved a pathologic response
In patients with a de novo diagnosis of breast cancer with synchronous distant metastases , surgery and radiotherapy result in considerably better locoregional tumor control .
An improvement in survival has not been consistently proven , but may exist in subgroups of patients .
Bei Patientinnen mit primärer Fernmetastasierung führt die lokale Beh and lung mittels Operation und/oder Strahlentherapie zur besseren lokalen Tumorkontrolle .
Aim The purpose of this work is to give practical guidelines for radiotherapy of locally advanced , inflammatory and metastatic breast cancer at first presentation .
ZusammenfassungZielZiel der Arbeit ist die Entwicklung von Praxis-Leitlinien zur Strahlentherapie des lokal fortgeschrittenen einschließlich des inflammatorischen Mammakarzinoms sowie zur lokalen Therapie bei synchroner Fernmetastasierung .
Ein Überlebensvorteil besteht wohl nicht , möglicherweise aber doch für einige Subgruppen der Patientinnen .