SIMULTANEOUS ADJUVANT RADIATION-THERAPY AND CHEMOTHERAPY IN HIGH-RISKBREAST-CANCER - TOXICITY AND DOSE MODIFICATION - A TRANS-TASMAN RADIATION ONCOLOGY GROUP MULTI-INSTITUTION STUDY
Jw. Denham et al., SIMULTANEOUS ADJUVANT RADIATION-THERAPY AND CHEMOTHERAPY IN HIGH-RISKBREAST-CANCER - TOXICITY AND DOSE MODIFICATION - A TRANS-TASMAN RADIATION ONCOLOGY GROUP MULTI-INSTITUTION STUDY, International journal of radiation oncology, biology, physics, 31(2), 1995, pp. 305-313
Citations number
25
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: To establish the toxicity profile of simultaneously administe
red postoperative radiation therapy and CMF chemotherapy as a prelude
to a randomized controlled study addressing the sequencing of the two
modalities. Methods and Materials: One hundred and thirty eight breast
cancer patients at high risk of locoregional, as well as systemic rel
apse, who were referred to three centers in Australia and New Zealand
were treated with postoperative radiation therapy and chemotherapy sim
ultaneously, Acute toxicity and dose modifications in these patients w
ere compared with 83 patients treated over the same time frame with ch
emotherapy alone. In a separate study the long-term radiation and surg
ical effects in 24 patients treated simultaneously with radiation ther
apy and chemotherapy at Newcastle (Australia) following conservative s
urgery were compared with 23 matched patients treated at Newcastle wit
h radiation therapy alone. Results: Myelotoxicity was increased in pat
ients treated simultaneously with radiation therapy and chemotherapy.
The effect was not great, but may have contributed to chemotherapy dos
e reductions. Lymphopenia was observed to be the largest factor in tot
al white cell depressions caused by the simultaneous administration of
radiation therapy, Postsurgical appearances were found to so dominate
long-term treatment effects on the treated breast that the effect of
radiation therapy dose and additional chemotherapy was difficult to de
tect. Conclusion: Studies addressing the sequencing of radiation thera
py and chemotherapy will necessarily be large because adverse effects
from administering the two modalities simultaneously are not great, Th
e present study has endorsed the importance in future studies of strat
ification according to the extent and type of surgery and adherence to
a single strict policy of chemotherapy dose modification.