Details

Autor(en) / Beteiligte

• Adams, Sylvia
• Chakravarthy, A. Bapsi
• Donach, Martin
• Spicer, Darcy
• Lymberis, Stella
• Singh, Baljit
• Bauer, Joshua A
• Hochman, Tsivia
• Goldberg, Judith D
• Muggia, Franco
• Schneider, Robert J
• Pietenpol, Jennifer A
• Formenti, Silvia C

Titel

Preoperative concurrent paclitaxel-radiation in locally advanced breast cancer: pathologic response correlates with five-year overall survival

Ist Teil von

• Breast cancer research and treatment, 2010-12, Vol.124 (3), p.723-732

Ort / Verlag

Boston: Boston : Springer US

Erscheinungsjahr

2010

Quelle

MEDLINE

Beschreibungen/Notizen

• 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.