Neoadjuvant sequential epirubicin and docetaxel followed by surgery-radiotherapy and post-operative docetaxel or gemcitabine/vinorelbine combination based on primary response: a multimodality approach for locally advanced breast cancer
| Autor: | Alexandros Ardavanis, Ioannis Missitzis, Pissakas G, Panteleimon Kountourakis, Dimitrios Doufexis, Anastasia Sotiropoulou, Vassileios Zobolas, Savoula Maliou, Niki Arnogiannaki |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Oncology Cancer Research medicine.medical_specialty medicine.medical_treatment Breast Neoplasms Docetaxel Kaplan-Meier Estimate Vinblastine Deoxycytidine Drug Administration Schedule Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols Biopsy medicine Humans Stage (cooking) Mastectomy Aged Epirubicin Chemotherapy medicine.diagnostic_test business.industry Patient Selection Vinorelbine General Medicine Middle Aged medicine.disease Gemcitabine Neoadjuvant Therapy Surgery Radiation therapy Treatment Outcome Chemotherapy Adjuvant Female Radiotherapy Adjuvant Taxoids business Progressive disease medicine.drug |
| Zdroj: | Journal of Cancer Research and Clinical Oncology. 137:221-228 |
| ISSN: | 1432-1335 0171-5216 |
| Popis: | Locally advanced breast cancer (LABC) remains a major clinical issue despite progress achieved in recent years. Herein, we present the mature results of a multimodality treatment program tailoring epirubicin (EPI), docetaxel (DOC) and gemcitabine–vinorelbine (GEV) peri-operatively in LABC. Stage III, Eastern Cooperative Oncology Group-Performance status ≤2 patients were eligible. A biopsy documentation had to be performed before the start of chemotherapy (CT). Treatment consisted of four EPI (100 mg/m2, d1q2w) followed by three DOC (100 mg/m2, d1q3w); surgery 3–4 weeks from CT completion, followed by radiation therapy (RT) and CT according to response; partial or complete (PR/CR):DOC, no change or progressive disease (NC/PD):GEV. Primary endpoints were: (a) response and conversion to operability/conservative surgery and (b) overall survival (OS) and time to recurrence (TTR). Fifty-six women, aged 32–75 (median 52 years), 24 IIIA and 32 IIIB were enrolled; 53 patients completed the entire program. Toxicity was acceptable and no treatment-related death was observed. Efficacy: clinical response rate (RR) 71.4% (40 patients); clinical complete response rate 33.9% (19 patients). Pathological response rate (RR) 67.8% (38 patients); pathological complete response rate 21.4% (12 patients). 33 (58.9%) and 19 (33.9%) patients, respectively, had radical and conservative operations without increased morbidity. After a median follow-up of 62 months, median OS has not yet been reached, while median TTR was 42 months. OS was longer in patients with clinical (p = 0.004) and pathological response (p = 0.002), RT (p |
| Databáze: | OpenAIRE |
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