Luigia Nardone1, Barbara Diletto2, Maria Carmen De Santis1, Giuseppe Roberto D' Agostino1, Paolo Belli3, Enida Bufi3, Gianluca Franceschini4, Antonino Mulé5, Anna Sapino6, Daniela Terribile4, Vincenzo Valentini1. 1. Department of Radiation Oncology, Catholic University of the Sacred Heart, Largo A. Gemelli, 1, 00168 Rome, Italy. 2. Department of Radiation Oncology, Catholic University of the Sacred Heart, Largo A. Gemelli, 1, 00168 Rome, Italy. Electronic address: diletto.b@gmail.com. 3. Department of Radiology, Catholic University of the Sacred Heart, Largo A. Gemelli, 1, 00168 Rome, Italy. 4. Department of Surgery, Catholic University of the Sacred Heart, Largo A. Gemelli, 1, 00168 Rome, Italy. 5. Department of Pathology, Catholic University of the Sacred Heart, Largo A. Gemelli, 1, 00168 Rome, Italy. 6. Department of Biomedical Science and Human Oncology, University of Torino, via Santena, 7, 10126 Torino, Italy.
Abstract
BACKGROUND: To evaluate the efficacy of preoperative low dose fractionated radiotherapy (LD-FRT) and chemotherapy in breast cancer. MATERIALS AND METHODS: Patients with stage IIA-IIIA breast cancer, received LD-FRT (0.40 Gy bid, on day 1 and 2, for 6 cycles) to primary tumor volume and concurrent chemotherapy with non-pegylated liposomal anthracycline and docetaxel. Pathological response was assessed by Mandard Tumor Regression Grade (TRG). We evaluated the pathological major response rate (PMRR) as TRG1 and TRG2. The expected outcome was a PMRR of 60%. The accrual was determined by the single proportion powered analysis (α = 0.05, power = 0.8). RESULTS: Twentyone patients were enrolled. No grade 2-4 acute skin and hematological toxicity was observed. TRG1 was obtained in 3 patients (14.3%), TRG2 in 4 patients (19%). The PMRR was 33.3%; it does not concur with the expected result, but is similar to that of chemotherapy alone. According to molecular subtype, 2/11 luminal A patients and 4/6 luminal B patients obtained a PMRR to preoperative treatment (35.3%); 1/4 basal like patients reported TRG1 (25%). CONCLUSIONS: LD-FRT concomitant with primary systemic treatment has a good toxicity profile. The response rate is consistent with that of chemotherapy alone, and suggests different interactions between low dose radiotherapy and molecular subtypes. Additional investigations are planned.
BACKGROUND: To evaluate the efficacy of preoperative low dose fractionated radiotherapy (LD-FRT) and chemotherapy in breast cancer. MATERIALS AND METHODS:Patients with stage IIA-IIIA breast cancer, received LD-FRT (0.40 Gy bid, on day 1 and 2, for 6 cycles) to primary tumor volume and concurrent chemotherapy with non-pegylated liposomal anthracycline and docetaxel. Pathological response was assessed by Mandard Tumor Regression Grade (TRG). We evaluated the pathological major response rate (PMRR) as TRG1 and TRG2. The expected outcome was a PMRR of 60%. The accrual was determined by the single proportion powered analysis (α = 0.05, power = 0.8). RESULTS: Twentyone patients were enrolled. No grade 2-4 acute skin and hematological toxicity was observed. TRG1 was obtained in 3 patients (14.3%), TRG2 in 4 patients (19%). The PMRR was 33.3%; it does not concur with the expected result, but is similar to that of chemotherapy alone. According to molecular subtype, 2/11 luminal A patients and 4/6 luminal B patients obtained a PMRR to preoperative treatment (35.3%); 1/4 basal like patients reported TRG1 (25%). CONCLUSIONS: LD-FRT concomitant with primary systemic treatment has a good toxicity profile. The response rate is consistent with that of chemotherapy alone, and suggests different interactions between low dose radiotherapy and molecular subtypes. Additional investigations are planned.
Authors: Maria C De Santis; Luigia Nardone; Barbara Diletto; Roberta Canna; Michela Dispinzieri; Lorenza Marino; Laura Lozza; Vincenzo Valentini Journal: Br J Radiol Date: 2016-07-25 Impact factor: 3.039
Authors: Joseph M Caster; Stephanie K Yu; Artish N Patel; Nicole J Newman; Zachary J Lee; Samuel B Warner; Kyle T Wagner; Kyle C Roche; Xi Tian; Yuanzeng Min; Andrew Z Wang Journal: Nanomedicine Date: 2017-03-11 Impact factor: 5.307