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Combination therapy shows improvement for breast cancer patients
December 01, 2006Giving radiation therapy and chemotherapy at the same time after a lumpectomy helps keep breast cancer from returning locally, according to a study published in the December 1 issue of the International Journal of Radiation OncologyBiologyPhysics, the official journal of ASTRO.
Breast cancer widely affects women in the United States, with more than 213,000 women estimated to be diagnosed in 2006. For early-stage breast cancer, the standard treatment is a lumpectomy (surgical removal of the tumor) followed by radiation therapy to the entire breast. Doctors usually recommend chemotherapy in addition for women with invasive disease. When to give the chemotherapy - whether after surgery, but before radiation or after surgery and radiation - has been widely debated among researchers.
Cancer researchers at Yale New Haven Hospital in New Haven, Conn., and the Cancer Institute of New Jersey, New Brunswick, N.J., wanted to try to answer the question as to the proper sequencing of chemotherapy. Doctors recorded data from more than 2,000 patients over the course of nearly 25 years. Of those women, 535 patients were treated with the different sequencing of chemotherapy and radiation therapy. Patients were then grouped by how they received the treatment, 276 women received chemotherapy before radiation therapy, 106 women received radiation therapy before chemotherapy, 109 women received concurrent chemotherapy and radiation and 44 women received the "sandwich" technique of alternating chemotherapy with radiation therapy and then repeating chemotherapy.
The outcome for the women in the study was successful across the group, with 10-year overall survival at 78 percent. Doctors found that there was no significant difference in the way these combinations affected the general patient outcome, but there was a difference in where tumors could relapse. Of the 109 patients who received chemotherapy and radiation therapy at the same time, only 8 percent relapsed locally (in the conservatively treated breast) over 10 years. Of the women who received radiation therapy before chemotherapy, 13 percent had a local relapse while 22 percent of the women who had chemotherapy before radiation had a local relapse.
"It is important for doctors to test and retest combinations of treatments and how we deliver them to our patients. In this retrospective analysis, by concurrently administering chemotherapy and radiation therapy, there appears to be a benefit to selected patients in terms of local control of the breast cancer. The challenge over the next few years is to identify those patients who would best benefit from this strategy. This can best be accomplished by prospective clinical trials," said Bruce G. Haffty, M.D., lead author of the study and a radiation oncologist at Robert Johnson Wood Medical School-UMDNJ and the Cancer Institute of New Jersey, in New Brunswick, N.J.
American Society for Therapeutic Radiology and Oncology
The outcome for the women in the study was successful across the group, with 10-year overall survival at 78 percent. Doctors found that there was no significant difference in the way these combinations affected the general patient outcome, but there was a difference in where tumors could relapse. Of the 109 patients who received chemotherapy and radiation therapy at the same time, only 8 percent relapsed locally (in the conservatively treated breast) over 10 years. Of the women who received radiation therapy before chemotherapy, 13 percent had a local relapse while 22 percent of the women who had chemotherapy before radiation had a local relapse.
"It is important for doctors to test and retest combinations of treatments and how we deliver them to our patients. In this retrospective analysis, by concurrently administering chemotherapy and radiation therapy, there appears to be a benefit to selected patients in terms of local control of the breast cancer. The challenge over the next few years is to identify those patients who would best benefit from this strategy. This can best be accomplished by prospective clinical trials," said Bruce G. Haffty, M.D., lead author of the study and a radiation oncologist at Robert Johnson Wood Medical School-UMDNJ and the Cancer Institute of New Jersey, in New Brunswick, N.J.
American Society for Therapeutic Radiology and Oncology
Chemotherapy Current Events and Chemotherapy News RSSFertility procedures need not delay breast cancer treatment for younger women
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Drugs to treat anemia in cancer patients linked to thromboembolism
Medications frequently given to cancer patients to reduce their risk of anemia are associated with an increased risk of deep vein thrombosis or pulmonary embolism, according to new research led by Dawn Hershman, M.D, M.S., co-director of the breast cancer program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital/Columbia University Medical Center.
For young boys with cancer, testicular tissue banking may be option to preserve fertility
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FDA approved leukemia drugs shows promise in ovarian cancer cells
The drug Sprycel, approved for use by the U.S. Food and Drug Administration in patients with chronic myeloid leukemia, significantly inhibited the growth and invasiveness of ovarian cancer cells and also promoted their death, a study by researchers with UCLA's Jonsson Comprehensive Cancer Center found.
1930s drug slows tumor growth
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First use of antibody and stem cell transplantation to successfully treat advanced leukemia
For the first time, researchers at Fred Hutchinson Cancer Research Center have reported the use of a radiolabeled antibody to deliver targeted doses of radiation, followed by a stem cell transplant, to successfully treat a group of leukemia and pre-leukemia patients for whom there previously had been no other curative treatment options.
New Synthetic Molecules Trigger Immune Response to HIV and Prostate Cancer
Researchers at Yale University have developed synthetic molecules capable of enhancing the body's immune response to HIV and HIV-infected cells, as well as to prostate cancer cells. Their findings, published online in the Journal of the American Chemical Society, could lead to novel therapeutic approaches for these diseases.
Chemo-radiation before prostate removal may prevent cancer recurrence
Researchers in the Oregon Health & Science University Knight Cancer Institute and the Portland Veterans Affairs Medical Center have found a combination of radiation therapy and chemotherapy given before prostate removal is safe and may have the potential to reduce cancer recurrence and improve patient survival.
PMH finding may help some tonsil cancer patients avoid chemotherapy
Clinical researchers at Princess Margaret Hospital (PMH) have confirmed that patients with oropharyngeal squamous cell cancer ("tonsil cancer") harbour a common type of human papilloma virus (HPV16), but also that such cancers are very sensitive to radiation.
Study of concurrent radiotherapy, chemotherapy shows promise in small cell lung cancer
Treating limited stage small cell lung cancer(LSCL) with a combination of accelerated high-dose radiotherapy and chemotherapy has shown encouraging results.
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