PURPOSE: The optimal sequencing of chemotherapy and radiation therapy in @entity1 with @entity0 undergoing breast-conservation treatment remains controversial. The purpose of this study is to evaluate the outcome of @entity1 treated with one specific sequence of concurrent chemoradiation followed by additional chemotherapy. METHODS: Between 1977 and 1992, 210 @entity1 with stage I and II @entity0 underwent lumpectomy and axillary lymph node dissection followed by treatment with concurrent chemotherapy and radiation therapy, followed by further chemotherapy. Chemotherapy consisted of two 28-day cycles of @entity1577 (oral @entity786 , 100 mg/m2 day 1 to 14, and intravenous @entity1487 , 600 mg/m2 days 1 and 8) during radiation therapy, followed in general by six cycles of CMF ( @entity1577 doses as above plus intravenous @entity1499 40 mg/m2 days 1 and 8) after the completion of radiation therapy. Fifty @entity1 also received hormonal therapy, predominantly @entity440 . One hundred ten @entity1 had clinical T1 lesions, and 100 had T2 lesions. Fifty-three @entity1 were pathologic N0, and 157 @entity1 were pathologic N1 (123 @entity1 had one to three positive nodes, and 34 @entity1 had four or more positive nodes). Median follow-up for node-negative @entity1 (5.2 years) is shorter than for node-positive @entity1 (7.6 years). Therefore, outcome is reported at 5 and 10 years for node-positive @entity1 but only at 5 years for node-negative @entity1 . RESULTS: For node-positive @entity1 , outcomes at 5 and 10 years, respectively, were 86% and 70% for overall survival, 78% and 67% for no evidence of disease survival, and 82% and 69% for freedom from distant metastases. For node-negative @entity1 , outcomes at 5 years were 94% for overall survival, 94% for no evidence of disease survival, and 94% for freedom from distant metastases. Pathologic nodal status was predictive of outcome after treatment. Local failure in the treated breast was 5% at 5 years and 13% at 10 years for all @entity1 . CONCLUSIONS: Concurrent @entity1577 with radiation therapy followed by six cycles of CMF after radiation therapy results in excellent survival, freedom from distant metastases, and local control for both node-negative and node-positive @entity1 . This regimen of concurrent chemotherapy and radiation therapy is one option for sequencing, and it avoids the delays in administration of either modality that are associated with other sequencing regimens.

Concurrent chemotherapy and radiation for breast conservation treatment of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer', 'early-stage breast cancer'] @entity440 :: ('MESH:D013629', 'Chemical') :: ['tamoxifen'] @entity786 :: ('MESH:D003520', 'Chemical') :: ['cyclophosphamide'] @entity1499 :: ('MESH:D008727', 'Chemical') :: ['methotrexate'] @entity1577 :: ('MESH:D003550', 'Disease') :: ['CF'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-fluorouracil']
@entity0 :: (MESH:D001943,Disease) :: ['early-stage breast cancer']
