Radiation Therapy & Chemotherapy After Breast-conserving Surgery Warrants Study

Concurrent Radiation Therapy and Chemotherapy After Breast-conserving Surgery Warrants Further Study

A study published in the International Journal of Radiation Oncology, Biology, Physics reports that administering radiation therapy at the same time as chemotherapy may reduce recurrence risk in women who have undergone breast-conserving surgery.

Early-stage breast cancer refers to cancer that is either confined to the breast or that has not spread beyond the axillary (underarm) lymph nodes. These cancers include ductal carcinoma in situ (DCIS) as well as Stage I, Stage II, and some Stage IIIA cancers. While some early-stage breast cancers are effectively treated with surgery and radiation therapy alone, others (particularly those that have spread to nearby lymph nodes) also require systemic treatments such as chemotherapy, hormonal therapy, or targeted therapy.

For women with early-stage breast cancer treated by lumpectomy, radiation therapy, and chemotherapy, researchers continue to evaluate the optimal sequencing of radiation therapy and chemotherapy.

To assess patient outcomes after different sequencing of radiation therapy and chemotherapy, researchers collected information from patients treated at the Yale New Haven Hospital. The study involved 535 patients with early-stage breast cancer treated between 1980 and 2003.

All patients had been treated with lumpectomy, radiation therapy, and chemotherapy. Many patients received chemotherapy with CMF (cyclophosphamide, methotrexate, and fluorouracil)-a regimen that is used less commonly now than in the past.

Radiation therapy was given before chemotherapy in 106 patients; chemotherapy was given before radiation therapy in 276 patients; chemotherapy was given both before and after radiation therapy in 44 patients; and 109 patients received chemotherapy and radiation therapy concurrently (at the same time).

  • Compared to the other groups of patients, women who received concurrent radiation therapy and chemotherapy were less likely to develop cancer recurrence in the treated breast.
  • Cosmetic results, toxicities, and rate of long-term complications were acceptable among women treated with concurrent radiation therapy and chemotherapy.

This study suggests that the concurrent administration of radiation therapy and chemotherapy may reduce the risk of cancer recurrence after breast conserving surgery. In order to confirm this finding, additional studies-using current chemotherapy regimens-would need to be conducted.

Reference: Haffty BG, Kim JG, Yang Q, Higgins SA. Concurrent Chemo-radiation in the Conservative Management of Breast Cancer. International Journal of Radiation Oncology, Biology, Physics. 2006;66:1306-1312.

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