To evaluate the tolerance of concomitant administration of anthracycline-based chemotherapy (CHT) and 3-dimensional conformal radiotherapy (RT) after breast-conserving surgery.
Sixty-seven patients, treated with conservative surgery followed by 3-dimensional whole breast RT and concomitant CHT regimens including “Canadian modified” CEF (5-fluorouracil, epirubicin, cyclophosphamide) or AC (doxorubicin, cyclophosphamide) were evaluated for toxicity. They were compared in terms in compliance and acute toxicity with 67 patients irradiated sequentially after having received anthracyclines.
Acute grade ≥2 skin toxicity was significantly higher in the concomitant group compared to the sequential group, although the incidence of Grade 3 desquamation showed no statistical difference (9% vs. 3%, p = 0.14). Haematological toxicity represented the main cause of treatment discontinuation, reporting higher rate of grade 3-4 leuco-neutropenia in the concomitant group (20.9% vs. 6%, p = 0.01). Mean RT duration was longer in the concomitant group (51 days vs. 45 days) owing to RT breaks. Late toxicity was acceptable. No symptomatic lung and heart events were reported. Radiological lung hyperdensity was detected in 27.7% of the patients in the concomitant group. Post-treatment left ventricular ejection fraction significantly decreased compared with baseline, but cardiac function remained within the normal range, without any difference between left or right-sided RT.
Although there was more acute grade ≥2 skin toxicity in the concomitant group, the rate of grade 3 dermatitis was lower than expected, suggesting some advantages of 3-D CRT over older techniques. Haematological toxicity exerted a significant impact on both RT and CHT delivery.
Tumori 2015; 101(1): 64 - 71
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsMaria Cristina Leonardi, Anna Morra, Luigi Santoro, Alessandra Balduzzi, Giovanni Battista Ivaldi, Barbara Vischioni, Annamaria Ferrari, Cristiana Fodor, Veronica Dell’Acqua, Daniela Maria Cardinale, Carlo Cipolla, Alberto Luini, Marco Colleoni, Barbara Alicja Jereczek-Fossa, Roberto Orecchia
- • Accepted on 09/05/2014
- • Available online on 13/02/2015
- • Published in print on 20/03/2015
This article is available as full text PDF.
- Leonardi, Maria Cristina [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Morra, Anna [PubMed] [Google Scholar] 1
- Santoro, Luigi [PubMed] [Google Scholar] 2
- Balduzzi, Alessandra [PubMed] [Google Scholar] 3
- Ivaldi, Giovanni Battista [PubMed] [Google Scholar] 4
- Vischioni, Barbara [PubMed] [Google Scholar] 5
- Ferrari, Annamaria [PubMed] [Google Scholar] 1
- Fodor, Cristiana [PubMed] [Google Scholar] 1
- Dell’Acqua, Veronica [PubMed] [Google Scholar] 1
- Cardinale, Daniela Maria [PubMed] [Google Scholar] 6
- Cipolla, Carlo [PubMed] [Google Scholar] 6
- Luini, Alberto [PubMed] [Google Scholar] 7
- Colleoni, Marco [PubMed] [Google Scholar] 3
- Jereczek-Fossa, Barbara Alicja [PubMed] [Google Scholar] 1, 8
- Orecchia, Roberto [PubMed] [Google Scholar] 1, 8
Division of Radiotherapy, European Institute of Oncology, Milan - Italy
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan - Italy
Research Unit in Medical Senology, Department of Medicine, European Institute of Oncology, Milan - Italy
Department of Radiation Oncology, Maugeri Foundation, Pavia - Italy
National Centre for Hadron Therapy (CNAO), Pavia - Italy
Division of Cardiology, European Institute of Oncology, Milan - Italy
Division of Senology, European Institute of Oncology, Milan - Italy
University of Milan, Milan - Italy