randomized trial of sequencing adjuvant chemotherapy and radiotherapy in lymph node positive premenopausal operable breast cancer

ABSTRACT

The objective of this study was to evaluate the value of the early initiation of either adjuvant chemotherapy or postoperative radiotherapy, considering the optimum and proper sequencing and gaping between both modalities. Between October 1998 and January 2000, 93 cases of premenopausal operable breast cancer with positive axillary lymph node were enrolled in this prospective study. Sixty-two patients underwent modified radical mastectomy and only thirty-one patients underwent conservative breast surgery. All patients received postoperative radiotherapy and adjuvant chemotherapy. They were classified according to the sequence of administration of chemotherapy and radiotherapy into three treatment groups. Group 1 was treated by early radiation therapy, group 2 was treated by sandwich technique, while group 3 was treated by delayed radiation therapy after the end of six cycles of chemotherapy. The sequence of the administration of chemotherapy and radiotherapy had an influence on the treatment failure and subsequently had an influence on the overall survival and disease-free survival rates. The extent of surgery was found to have an influence on the treatment failure and disease-free survival