Primary systemic treatment of @entity0 with cytotoxics yields a high response rate and allows conservative surgical procedures in bulky @entity5 . In order to maximise local control of disease, two innovations were introduced in a pilot study. The first was to identify the good responders after three cycles of chemotherapy and to treat them with three additional cycles. The second was to also give this group of @entity1 a full dose of radiotherapy before surgery with the aim of verifying the rate of pathological complete remissions in view of a possible treatment of breast primary with chemoradiotherapy only. @entity1 were treated with @entity632 60 mg/m2 and @entity786 , 600 mg/m2 both intravenously on day 1, every 21 days for three courses. Partial or complete responders received three more courses followed by radiotherapy (50 Gy plus a 10 Gy boost). The others underwent immediate surgery. A total of 32 @entity1 (median age, 50 years; range 28-69 years); performance status, 0-1; T2 22, T3 8, T4 2) were enrolled and were evaluable for response and side-effects. 9 @entity1 had only three cycles of chemotherapy due to absence of response and 23 @entity1 had six cycles of chemotherapy. Overall, 7 @entity1 had a complete remission, 16 a partial remission and 9 had stable disease, for an overall response rate of 72% (95% confidence interval 53-86%). In the group of @entity1 that completed the programme, two complete pathological remissions were observed and 5 @entity1 had only microfoci of @entity5 . No toxic death or grade III-IV @entity137 were observed. Mild or moderate side-effects included @entity33 , @entity1209 and @entity1210 . In conclusion, our results indicate that the addition of radiotherapy to pre-operative chemotherapy did not significantly enhance the incidence of pathological complete remissions. New primary treatment approaches should be explored in this subset of @entity1 in order to improve outcome.

Pre-operative chemotherapy and radiotherapy in XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity632 :: ('MESH:D004317', 'Chemical') :: ['doxorubicin'] @entity1210 :: ('MESH:C536227', 'Disease') :: ['leucopenia'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicities'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumours', 'tumour'] @entity33 :: ('MESH:D052016', 'Disease') :: ['mucositis'] @entity786 :: ('MESH:D003520', 'Chemical') :: ['cyclophosphamide'] @entity1209 :: ('MESH:D020250', 'Disease') :: ['nausea/vomiting']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
