SIMULTANEOUS ADJUVANT RADIATION-THERAPY AND CHEMOTHERAPY IN HIGH-RISKBREAST-CANCER - TOXICITY AND DOSE MODIFICATION - A TRANS-TASMAN RADIATION ONCOLOGY GROUP MULTI-INSTITUTION STUDY

Citation
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
ISSN journal
03603016
Volume
31
Issue
2
Year of publication
1995
Pages
305 - 313
Database
ISI
SICI code
0360-3016(1995)31:2<305:SARACI>2.0.ZU;2-1
Abstract
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.