Intraarterial infusion chemotherapy and radiotherapy with of without surgery for patients with locally advanced or recurrent breast cancer

We analyzed response, side effects, and local control rates of a multimodal treatment consisting of intraaterial infusion chemotherapy (IAIC) and radi otherapy with or without surgery for patients with locally advanced or recu rred breast cancer. Thirty-three patients, clinically diagnosed as stage II B in 1, ILIA in 2, IIIB in 12, IV in 18, were treated from 1991 to 1998. Tw enty-five were primary and eight were recurrent cases after surgery. IAIC s tarted as initial treatment up to three times maximum. In most cases, doxor ubicin 50 mg, cisplatin 50 mg, and mitomycin 10 mg were infused in the subc lavian and/or internal mammary artery. After IAIC, patients in primary case s underwent radical mastectomy or breast conservation surgery, after radiot herapy at a total dose of 50 Gy/25 fractions/5 weeks with a boost of 10 Gy. In recurrent cases, a full dose of radiotherapy was delivered. Clinical ob jective and complete response rates were 78% and 9% after IAIC. Despite a h igh rate of residual positive margin (67%) or clinically residual carcinoma , local recurrence developed only in 2 patients (6%) and local control rate s at 5 years were calculated as 89%. Bone marrow suppression was frequent, and skin vesiculation (15%) and ulceration (9%) were experienced after IAIC . Skin ulcer (6%), brachial plexus neuropathy (3%), and radiation pneumonit is (3%) occurred as late toxicity. IAIC was effective as an induction treat ment and radiotherapy played a role of local control for patients with loca lly advanced or recurrent breast cancer.