Concurrent cyclophosphamide, methotrexate, and 5-fluorouracil chemotherapy and radiotherapy for early breast carcinoma

International Journal of Radiation Oncology, Biology, Physics
Lorenzo LiviGian Paolo Biti

Abstract

The optimal sequencing of adjuvant chemotherapy (CT) and radiation therapy (RT) in patients with early-stage breast cancer remains unclear. We retrospectively compared 485 patients treated with conservative breast surgery and postoperative whole-breast RT and six courses of CMF (cyclophosphamide 600 mg/m(2), methotrexate 40 mg/m(2), and 5-fluorouracil 600 mg/m(2)) with 300 patients who received postoperative CMF only and with 509 patients treated with postoperative whole-breast RT only. The mean radiation dose delivered was 50 Gy (range, 46-52 Gy) with standard fractionation. The boost dose was 6-16 Gy according to resection margins and at the discretion of the radiation oncologist. Acute and late RT toxicity were scored using respectively the Radiation Therapy Oncology Group and the Late Effects in Normal Tissues Subjective, Objective, Management and Analytic scale. A slightly higher Grade 2 acute skin toxicity was recorded in the concurrent group (21.2% vs. 11.2% of the RT only group, p < 0.0001). RT was interrupted more frequently in the CMF/RT group respective to the RT group (8.5% vs. 4.1%; p = 0.006). There was no difference in late toxicity between the two groups. All patients in the concurrent group successfully receive...Continue Reading

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Citations

Jul 14, 2009·Radiation Oncology·Alberto Alvarado-MirandaFernando Lara-Medina
Sep 28, 2010·The Breast : Official Journal of the European Society of Mastology·Marcin SinackiJacek Jassem
May 26, 2009·Clinical Oncology : a Journal of the Royal College of Radiologists·N S Bese
Aug 21, 2013·The Breast : Official Journal of the European Society of Mastology·Lena SharpMia Bergenmar

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