ABSTRACT
CONTEXT: As of today, there is no validated standard method to assess clinical response of breast cancer to neo- adjuvant chemotherapy (NACT). Some centers use clinical dimensions while others use radiological measurements to evaluate response according to RECIST criteria. AIMS: The aim was to correlate and compare the clinical, radiological, and pathological parameters for assessing the tumor response in patients of breast cancer receiving NACT. SETTINGS AND DESIGN: Single institution, prospective nonrandomized study conducted over a 2-year period. MATERIALS AND METHODS: Patients with diagnosed breast cancer were assessed for response to NACT prior to surgery using clinical and radiological techniques. This was correlated with pathological reponse which was assessed by measuring gross dimensions and Miller-Payne grading of response to chemotherapy. STATISTICAL ANALYSIS USED: Spearman’s rho nonparametric. RESULTS: Fifty two patients completed the evaluation (out of 313 cases of ca breast treated during the same period) with a median age of 52.5 years. We noted a 26.9% clinical complete response (CR) and 19.2% had pathological CR. Clinical evaluation had a sensitivity and specificity of 73.5% and 88.5% respectively compared to 14.2% and 100% respectively for radiological assessment. CONCLUSIONS: Clinical assessment of response to NACT shows a higher sensitivity compared to radiological assessment. However the overall low sensitivity and specificity rates of clinical assessment mandate a search for a better method of evaluation.
Subject(s)
Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Breast Neoplasms/radiotherapy , Carcinoma, Ductal, Breast/drug therapy , Carcinoma, Ductal, Breast/pathology , Carcinoma, Ductal, Breast/radiotherapy , Chemotherapy, Adjuvant , Female , Follow-Up Studies , Humans , Middle Aged , Neoadjuvant Therapy , Neoplasm Staging , Prognosis , Prospective Studies , ROC Curve , Remission InductionABSTRACT
This study evaluated the effects of prolonged primary chemotherapy in retinoblastoma. The data for 27 eyes in 22 children who were treated for retinoblastoma with up to 13 cycles of primary chemotherapy was reviewed. The chemotherapy consisted of etoposide, vincristine, and either carboplatin or ifosfamide. In bilateral retinoblastoma, 1 eye was in each Ia, Ib, and Va, according to the Reese-Ellsworth classification, 2 in each IIa, IIIa, and IIIb, 4 in IIb, and 5 in IVa. Enucleation was performed in 1 in IIa and 1 in Va. In unilateral, 1 was in each IIa, IIIa, IVa, IVb, and Vb, and 4 in Va. Enucleation was performed in 8 with the exception of 1 in IIa. Complete regression was observed in 17 eyes (12 patients). There was no toxicity severe enough to delay treatment. Prolonged primary chemotherapy can be considered as an alternative treatment for retinoblastoma in III or less.