ABSTRACT
BACKGROUND AND OBJECTIVES: Chemotherapy and radiotherapy have been investigated in several studies about their role in primary (neoadjuvant) treatment before surgery in breast cancer. We proposed a pilot study to evaluate a primary scheme of alternate radio-chemotherapy in the treatment of operable (T2- small T3) breast cancer. METHODS: 14 patients were recruited. Cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) were administered on days 1 and 8, every 4 wk, for two cycles. Radiotherapy was administered during the 3rd and 4th wk (5 d/wk) after the beginning of chemotherapy. The patients were operated on within 24 wk. All the patients received four additional cycles of chemotherapy within 1 mo after surgery. RESULTS: We observed: 1 (8.3%) complete remission (CR), 8 (66.7%) partial remission (PR), 3 (25%) stationary disease (SD); no progressive disease was observed. Modified radical mastectomy was performed on 7 patients (58.3%). Conservative surgery was performed on 5 cases (41.7%). No major complications were observed. No patient has shown local or distant recurrence. CONCLUSIONS: This study shows the feasibility of a primary chemoradiotherapy treatment for breast cancer. But to evaluate the impact of this therapy on overall survival and recurrence risk and its possible introduction in clinical practice, we need larger series and longer follow-up.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/therapy , Mastectomy, Modified Radical , Adult , Aged , Breast Neoplasms/drug therapy , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Chemotherapy, Adjuvant , Cisplatin/administration & dosage , Combined Modality Therapy , Drug Administration Schedule , Feasibility Studies , Female , Fluorouracil/administration & dosage , Humans , Methotrexate/administration & dosage , Middle Aged , Pilot Projects , Radiotherapy DosageABSTRACT
Radiation therapy fulfills all the requirements to be used with curative or palliative intent in nearly every case of cancer in the elderly. Radiotherapy is not associated with acute mortality in older persons and can permit organ and tissue preservation. The modern modalities to deliver radiotherapy treatment permit a large sparing of normal tissues. We need major information on proliferative activity of normal tissues and cancer in the elderly, on results according to stage of tumors, and on acute and late sequelae according to performance status of the patient. It is mandatory to perform prospective studies in order to work out protocols for oncologic treatments and specifically for radiotherapy, to treat adequately an increasing part of population.
Subject(s)
Aged , Neoplasms/radiotherapy , Age Factors , Clinical Protocols , Female , Humans , Incidence , Male , Neoplasm Staging , Neoplasms/epidemiology , Neoplasms/pathology , Treatment OutcomeABSTRACT
We report the case of a 54-year-old female patient with postoperative hypoparathyroidism. Despite the fact that she was receiving calcitriol replacement therapy, following the appearance of bone metastases due to breast cancer she developed severe crises of hypo- and hypercalcemia.
Subject(s)
Breast Neoplasms/complications , Hypercalcemia/etiology , Hypocalcemia/etiology , Parathyroidectomy , Bone Neoplasms/secondary , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Calcitriol/therapeutic use , Female , Humans , Hypocalcemia/drug therapy , Hypoparathyroidism/etiology , Middle Aged , Postoperative ComplicationsABSTRACT
Two new cases of primary mediastinal seminoma are presented and 126 cases from the literature are analysed. Radiotherapy, alone or combined with surgery, is thought by some authors to be the treatment of choice and the role of chemotherapy is uncertain. We propose a classification by which it is possible to compare various therapeutic approaches and to establish their value.
