Combination chemotherapy and radiation therapy in locally advanced breast cancer

This study aimed to find out if radiation added to standard chemotherapy could increase the response to treatment for locally advanced breast cancer. This study found that neoadjuvant radiation added to chemotherapy improved response but not overall survival. 

Chemotherapy is a treatment option for locally advanced breast cancer. It can be used neoadjuvantly, which means it is used before breast conserving surgery (removal of area around the tumor) or a mastectomy (complete removal of breast tissue) is done. Radiation therapy and chemotherapy used together can be more effective at treating cancer. The effectiveness of chemotherapy and radiotherapy in a neoadjuvant setting for locally advanced breast cancer is unclear. 

This study aimed to determine whether radiation added to standard chemotherapy could increase the response to treatment for locally advanced breast cancer (LABC). It included 32 patients who received 3 cycles of chemotherapy (5-fluorouracil, epirubicin, and cyclophosphamide), followed by nine cycles of weekly docetaxel combined with radiation treatment. This was followed by surgery.

The pathological complete response (absence of cancer cells in the original tumor site) rate was 22.6% for patients on this regimen compared to 14.9% who did not have neoadjuvant chemotherapy and radiotherapy. There was no significant difference in disease-free and overall survival (time from treatment until death from any cause) at 3 years.

25% of patients experienced pneumonitis (inflammation of the lungs) and 25% of patients experienced skin reactions. One patient died during treatment. The trial ended early due to side-effects. 

This study found that neoadjuvant radiation added to chemotherapy improved pathological response but not overall survival. It led to a high rate of side-effects. 

This study compares the patients that are treated to statistical data, and therefore it is not a randomized trial. This means the evidence is not as strong.