The sequencing of chemotherapy and radiation therapy after conservative surgery for early-stage breast cancer

The New England Journal of Medicine
A RechtJ R Harris

Abstract

Patients with early-stage breast cancer who are at substantial risk for systemic metastases are increasingly treated with breast-conserving therapy and adjuvant chemotherapy. However, the optimal sequencing of chemotherapy and radiation therapy is not clear. Two hundred forty-four patients with stage I or II breast cancer who were at substantial risk for distant metastases were randomly assigned to receive a 12-week course of chemotherapy either before or after radiation therapy. All had had breast-conserving surgery. The median length of follow-up in surviving patients was 58 months (range, 10 to 124). The five-year actuarial rates of cancer recurrence at any site and of distant metastases in the radiotherapy-first group and the chemotherapy-first group were 38 percent and 31 percent (P = 0.17) and 36 percent and 25 percent (P = 0.05), respectively. Overall survival was 73 percent and 81 percent (P = 0.11), respectively. The five-year crude rates of first recurrence according to site in the radiotherapy-first and chemotherapy-first groups, respectively, were 5 percent and 14 percent for local recurrence and 32 percent and 20 percent for distant or regional recurrence or both. This difference in the pattern of recurrence was of...Continue Reading

References

Feb 1, 1979·International Journal of Radiation Oncology, Biology, Physics·J R HarrisS Hellman
Jan 1, 1992·Frontiers of Radiation Therapy and Oncology·B Fowble
Jul 1, 1992·American Journal of Clinical Pathology·S J Schnitt, J L Connolly
Sep 1, 1991·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·A RechtJ L Connolly
Mar 1, 1990·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·R GelmanJ R Harris
Sep 15, 1988·The New England Journal of Medicine·UNKNOWN Ludwig Breast Cancer Study Group
Jan 1, 1982·Breast Cancer Research and Treatment·A U BuzdarE A Gehan
Nov 1, 1995·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M R SertoliE Campora
May 1, 1993·Trends in Biotechnology·T Friedmann, H A Jinnah
May 5, 1994·The New England Journal of Medicine·W C WoodC R Ferree
Aug 30, 1994·International Journal of Radiation Oncology, Biology, Physics·L B Marks, L R Prosnitz
Apr 30, 1993·International Journal of Radiation Oncology, Biology, Physics·T A BuchholzT W Griffin
Dec 1, 1995·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·C E LeonardS Sedlacek
Jan 1, 1994·Alzheimer Disease and Associated Disorders·Greg A Sachs
Aug 31, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·S Eva SingletaryFrederick L Greene

❮ Previous
Next ❯

Citations

Feb 17, 2001·Breast Cancer : the Journal of the Japanese Breast Cancer Society·J Stebbing J, A Gaya
Nov 28, 2012·Langenbeck's Archives of Surgery·Rozbeh TorabiIan K Komenaka
Nov 27, 2004·Breast Cancer Research and Treatment·Nicole Hébert-CroteauJacques Brisson
Aug 17, 2010·Breast Cancer Research and Treatment·Umberto VeronesiPatrick Maisonneuve
May 17, 2012·Breast Cancer Research and Treatment·Thomas M SchroederMelanie Royce
Sep 9, 2006·Radiation Medicine·Naoyuki ShigematsuAtsushi Kubo
Jun 12, 2002·Current Treatment Options in Oncology·A C Wolff, N E Davidson
Feb 22, 2003·Current Treatment Options in Oncology·Hope S Rugo
Jul 1, 1996·International Journal of Radiation Oncology, Biology, Physics·J R Harris
Apr 20, 2004·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·T PetitC Carrie
Apr 20, 2004·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·G Calais
Sep 29, 2004·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·C HanzenY Graïc
Feb 11, 2004·Clinical Oncology : a Journal of the Royal College of Radiologists·M BackA Steigler
Mar 9, 2005·International Journal of Radiation Oncology, Biology, Physics·Johnny KaoRuth Heimann
Apr 6, 2004·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Margot LehmanMichael Barton
Nov 26, 1999·The Surgical Clinics of North America·F J Esteva, G N Hortobagyi
Nov 26, 1999·The Surgical Clinics of North America·A G Taghian, S N Powell
Jan 1, 1999·Journal of Nurse-midwifery·W F McCoolH M Bradford
Sep 15, 1999·Current Problems in Cancer
Oct 31, 2000·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·V DoM B Barton
Sep 7, 2000·International Journal of Radiation Oncology, Biology, Physics·J R BellonM M Austin Seymour
Apr 17, 2002·International Journal of Radiation Oncology, Biology, Physics·David L SchwartzGeorge E Laramore
Oct 25, 2003·International Journal of Radiation Oncology, Biology, Physics·Melanie C SmittStefanie S Jeffrey
Apr 8, 1998·International Journal of Radiation Oncology, Biology, Physics·P H ElkhuizenJ W Leer
Feb 16, 1999·International Journal of Radiation Oncology, Biology, Physics·E TouboulM Housset
Nov 26, 1999·International Journal of Radiation Oncology, Biology, Physics·A DubeyL N Shulman
Feb 8, 2000·International Journal of Radiation Oncology, Biology, Physics·P J FroudI A Olivotto
Mar 13, 2002·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·M Overgaard
Jan 20, 2004·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·P B OttevangerL V A M Beex
Aug 17, 1999·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·P B OttevangerL V Beex
Mar 25, 2000·Surgical Oncology·A C Wolff, M D Abeloff
Dec 9, 2003·The Breast : Official Journal of the European Society of Mastology·Harry Bartelink
Mar 8, 2002·Breast Cancer Research and Treatment·Robert J EllisJohn P Fruehauf
Aug 2, 2002·Breast Cancer Research and Treatment·N Hébert-CroteauJ Brisson
Sep 11, 2002·Breast Cancer Research and Treatment·Damian R Beil, Lawrence M Wein
Nov 3, 2005·Nature Clinical Practice. Oncology·Matthew S KatzKevin S Hughes
Apr 28, 2011·Nature Reviews. Clinical Oncology·Elizabeth ComenJoan Massagué
Aug 28, 2002·Australasian Radiology·Matthew Seel, Farshad Foroudi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Breast Invasive Carcinoma

Invasive breast cancers indicate a spread into breast tissues and lymph nodes. Here are the latest discoveries pertaining to breast invasive carcinomas.

Breast Invasive Carcinoma (Keystone)

Invasive breast cancers indicate a spread into breast tissues and lymph nodes. Here are the latest discoveries pertaining to breast invasive carcinomas.