Neoadjuvant chemotherapy followed by neoadjuvant concurrent chemoradiation for locally advanced breast cancer: a feasibility study and 10-year follow-up results

Kunheri, Beena; Kottarathil, Vijaykumar Dehannathparambil; Makuny, Dinesh; Pavithran, Keechilat; Padmanabhan, T. K.

doi:10.1007/s40944-016-0088-7

Cited by 2 publications

(2 citation statements)

References 9 publications

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“… 29 A similar study evaluated NAC with AC initially followed by concurrent chemoradiation with twice weekly paclitaxel in LABC. 30 The outcome of other studies in patients with LABC is mentioned in Appendix Table A 6 . Currently, a randomized trial is being conducted in our institute comparing chemoradiation and chemotherapy in the initial management of LABC.…”

Section: Discussionmentioning

confidence: 99%

Locally Advanced Breast Cancer (LABC): Real-World Outcome of Patients From Cancer Institute, Chennai

Dhanushkodi

Sridevi

Shanta

et al. 2021

JCO Global Oncology

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PURPOSE There are sparse data on the outcome of patients with locally advanced breast cancer (LABC). This report is on the prognostic factors and long-term outcome from Cancer Institute, Chennai. METHODS This is an analysis of untreated patients with LABC (stages IIIA-C) who were treated from January 2006 to December 2013. RESULTS Of the 4,577 patients with breast cancer who were treated, 2,137 patients (47%) with LABC were included for analysis. The median follow-up was 75 months (range, 1-170 months), and 2.3% (n = 49) were lost to follow-up at 5 years. The initial treatment was neoadjuvant concurrent chemoradiation (NACR) (77%), neoadjuvant chemotherapy (15%), or others (8%). Patients with triple-negative breast cancer had a pathologic complete response (PCR) of 41%. The 10-year overall survival was for stage IIIA (65.1%), stage IIIB (41.2%), and stage IIIC (26.7%). Recurrence of cancer was observed in 27% of patients (local 13% and distant 87%). Multivariate analysis showed that patients with a tumor size > 10 cm (hazard ratio [HR], 2.19; 95% CI, 1.62 to 2.98; P = .001), hormone receptor negativity (HR, 1.45; 95% CI, 1.22 to 1.72; P = .001), treatment modality (neoadjuvant chemotherapy, HR, 0.56; 95% CI, 0.43 to 0.73; P = .001), lack of PCR (HR, 2.36; 95% CI, 1.85 to 3.02; P = .001), and the presence of lymphovascular invasion (HR, 1.97; 95% CI, 1.60 to 2.44; P = .001) had decreased overall survival. CONCLUSION NACR was feasible in inoperable LABC and gave satisfactory long-term survival. PCR was significantly higher in patients with triple-negative breast cancer. The tumor size > 10 cm was significantly associated with inferior survival. However, this report acknowledges the limitations inherent in experience of management of LABC from a single center.

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Section: Discussionmentioning

confidence: 99%

Locally Advanced Breast Cancer (LABC): Real-World Outcome of Patients From Cancer Institute, Chennai

Dhanushkodi

Sridevi

Shanta

et al. 2021

JCO Global Oncology

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“…[ 2 ] Paclitaxel and docetaxel are two anticancer drugs that have been successfully used in chemotherapy for various cancers such as breast, ovarian, lung, bladder, prostate, melanoma, oesophageal, and other types of solid tumour cancers. [ 3 , 4 ] By inhibiting microtubules, taxane causes neurotoxicity that might necessitate the discontinuation of chemotherapy due to decrease in quality of life in patients. It was found that debilitating taxane-induced arthralgia and myalgia are the greater clinical challenge.…”

Section: Introductionmentioning

confidence: 99%

Flupirtine in the Management of Taxane-induced Pain in Cancer Patients

Paul

Razak

Binoy

et al. 2021

IJPC

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Objectives: Paclitaxel and docetaxel are two commonly used chemotherapeutic agents in the treatment of various types of cancers. However, debilitating taxane-induced arthralgia and myalgia are among the most common adverse reactions associated with taxanes, which has greatly influenced medical practitioners. Most of the mild and moderate analgesics were found to be less effective in the management of taxane induced pain. So we used flupirtine, a non-opioid analgesic, in the treatment of taxane-induced pain. Materials and Methods: In this study, we analysed the baseline pain score and follow-up data of 60 patients receiving a taxane-based chemotherapy regimen. Baseline data of these study populations experiencing significant taxane-induced pain were compared with follow-up data after treating them with analgesic flupirtine (200 mg/day). The baseline and follow-up data representing pain were assessed with the help of the Visual Analogue Scale (VAS), and the quality of life was determined using the Brief Pain Inventory (BPI) scale questionnaire. Results: The mean baseline and follow-up VAS score was compared using paired sample t-test, which showed a significant reduction in taxane-induced pain after treatment with flupirtine (P < 0.001). Similarly, the mean BPI score representing the quality of life before and after treatment with flupirtine was compared, and a notable improvement in quality of life was seen after treatment with flupirtine. The mean and follow-up data of aspartate aminotransferase and alanine aminotransferase levels of patients were also compared to assess the adverse drug reaction profile of the drug, and the analyzed data was found to be statistically insignificant (no significant liver toxicity) which indicates that drug can be used effectively for a period of <2 weeks. Conclusion: We believe that flupirtine can be used as an effective analgesic in dire situations where patients require opioid analgesics for the management of taxane-induced pain, provided that the drug is given for <2 weeks to avoid drug-related hepatotoxicity.

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Neoadjuvant chemotherapy followed by neoadjuvant concurrent chemoradiation for locally advanced breast cancer: a feasibility study and 10-year follow-up results

Cited by 2 publications

References 9 publications

Locally Advanced Breast Cancer (LABC): Real-World Outcome of Patients From Cancer Institute, Chennai

Locally Advanced Breast Cancer (LABC): Real-World Outcome of Patients From Cancer Institute, Chennai

Flupirtine in the Management of Taxane-induced Pain in Cancer Patients

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