Results of a conservative treatment combining induction (neoadjuvant) and consolidation chemotherapy, hormonotherapy, and external and interstitial irradiation in 98 patients with locally advanced breast cancer (IIIA-IIIB)

Abstract

Ninety-eight patients with locally advanced breast cancer (Stage IIIA-IIIB) were entered into a pilot study combining intensive induction (neoadjuvant) chemotherapy (VTMFAP) with or without hormonochemotherapy, external and interstitial radiotherapy, and consolidation chemotherapy with or without hormonochemotherapy. Tumor regression over 50% was observed in 91% patients after chemotherapy, and complete clinical remission occurred in 100% patients after irradiation. The rate of local relapse is 13%. The 3-year disease-free survival is 62% and 3-year global survival is 77%. Initial chemotherapeutic tumor regression greater than 75% is the main predictive factor for disease-free survival.

Multimodality treatment of noninflammatory stage IIIb breast cancer

“…After four or five courses of FAC regimen chemotherapy, 14% of our III B NIBC patients achieved complete clinical response (CR) and 69% had partial response (PR). These results concur with most of those reported in the literature where the CR ranges from 0% to 50%, and PR from 34% to 85% [9,10,[17][18][19][20][21][22][23][24][25][26][27][28][29]. In 21 patients (7%) of our group, a pathologic complete response of the disease (pT0, pN0) was obtained.…”

“…In the group of 30 women with locally advanced breast cancer treated by Gasparini et al,year survival was 77% for complete responders compared, with 24% for others [34]. Tumor regression after neoadjuvant chemotherapy was also the main predictive factor for disease-free survival in a group of 98 patients presented by Jacquillat et al; the rate of relapse was 34% for patients with regression >75% and 54% for those with less marked regression [17]. In the group presented by Hortobagyi et al, 5-year NED survival rates for patients with complete response, partial response, no change, and progressive disease were 83%, 36%, 19%, and 0%, respectively [19].…”

“…The opinions on correlation between the clinical response to neoadjuvant chemotherapy and the prognosis vary. Some question the existence of this correlation [11,23,41,42], but it was found in the analysis of most authors [3,5,7,17,19,32,34,38,39,[43][44][45]. In the group of 30 women with locally advanced breast cancer treated by Gasparini et al,year survival was 77% for complete responders compared, with 24% for others [34].…”

Primary systemic therapy for operable breast cancer

“…patients with ER-poor or ER-negative tumours). The proportion of such patients with tumours which were chemosensitive was high and lies within the observed range of 70-93% described with 'neoadjuvant' chemotherapy in more locally advanced breast cancers (Jacquillat et al, 1988;Hortobagyi et al, 1988;Swain et al, 1987). Of those individual tumours directly demonstrated as endocrine-resistant however the proportion of ER-poor/ negative tumours regressing with chemotherapy paralleled that of primary chemotherapy (-80%) In addition to the benefit of selecting appropriate systemic therapy, there is theoretical (Goldie & Coldman, 1979;Skipper 1964), experimental (Fisher et al, 1983) and clinical (Nissen-Meyer et al, 1986;Ragaz, 1986) …”

Study on the role of primary systemic chemotherapy with anthracycline combination schedule in locally advanced breast cancer: long term follow up data

“…But approximately 10-20% of patients get complete clinical response and 50-60% achieves a partial response. [24][25][26][27][28][29][30] Thus it proves beyond doubt the role of Anthracycline combination schedule in Indian women in tumour response.…”