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Ciérvide R, Montero Á, García-Rico E, García-Aranda M, Herrero M, Skaarup J, Benassi L, Barrera MJ, Vega E, Rojas B, Bratos R, Luna A, Parras M, López M, Delgado A, Quevedo P, Castilla S, Feyjoo M, Higueras A, Prieto M, Suarez-Gauthier A, Garcia-Cañamaque L, Escolán N, Álvarez B, Chen X, Alonso R, López M, Hernando O, Valero J, Sánchez E, Ciruelos E, Rubio C. Primary Chemoradiotherapy Treatment (PCRT) for HER2+ and Triple Negative Breast Cancer Patients: A Feasible Combination. Cancers (Basel) 2022; 14:cancers14184531. [PMID: 36139688 PMCID: PMC9496977 DOI: 10.3390/cancers14184531] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 12/02/2022] Open
Abstract
Primary systemic treatment (PST) downsizes the tumor and improves pathological response. The aim of this study is to analyze the feasibility and tolerance of primary concurrent radio−chemotherapy (PCRT) in breast cancer patients. Patients with localized TN/HER2+ tumors were enrolled in this prospective study. Radiation was delivered concomitantly during the first 3 weeks of chemotherapy, and it was based on a 15 fractions scheme, 40.5 Gy/2.7 Gy per fraction to whole breast and nodal levels I-IV. Chemotherapy (CT) was based on Pertuzumab−Trastuzumab−Paclitaxel followed by anthracyclines in HER2+ and CBDCA-Paclitaxel followed by anthracyclines in TN breast cancers patients. A total of 58 patients were enrolled; 25 patients (43%) were TN and 33 patients HER2+ (57%). With a median follow-up of 24.2 months, 56 patients completed PCRT and surgery. A total of 35 patients (87.5%) achieved >90% loss of invasive carcinoma cells in the surgical specimen. The 70.8% and the 53.1% of patients with TN and HER-2+ subtype, respectively, achieved complete pathological response (pCR). This is the first study of concurrent neoadjuvant treatment in breast cancer in which three strategies were applied simultaneously: fractionation of RT (radiotherapy) in 15 sessions, adjustment of CT to tumor phenotype and local planning by PET. The pCR rates are encouraging.
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Affiliation(s)
- Raquel Ciérvide
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Correspondence: (R.C.); (E.G.-R.); Tel.: +34-669554042 (R.C.); +34-609165218 (E.G.-R.)
| | - Ángel Montero
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Eduardo García-Rico
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
- Correspondence: (R.C.); (E.G.-R.); Tel.: +34-669554042 (R.C.); +34-609165218 (E.G.-R.)
| | | | - Mercedes Herrero
- Department of Gynecology and Obstetrics, HM Hospitales, 28050 Madrid, Spain
| | - Jessica Skaarup
- Department of Gynecology and Obstetrics, HM Hospitales, 28050 Madrid, Spain
| | - Leticia Benassi
- Department of Gynecology and Obstetrics, HM Hospitales, 28050 Madrid, Spain
| | - Maria José Barrera
- Department of Gynecology and Obstetrics, HM Hospitales, 28050 Madrid, Spain
| | - Estela Vega
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Beatriz Rojas
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Raquel Bratos
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Ana Luna
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Manuela Parras
- Department of Radiology, HM Hospitales, 28050 Madrid, Spain
| | - María López
- Department of Radiology, HM Hospitales, 28050 Madrid, Spain
| | - Ana Delgado
- Department of Radiology, HM Hospitales, 28050 Madrid, Spain
| | - Paloma Quevedo
- Department of Radiology, HM Hospitales, 28050 Madrid, Spain
| | | | - Margarita Feyjoo
- Department of Medical Oncology, Hospital Sanitas La Moraleja, 28050 Madrid, Spain
| | - Ana Higueras
- Department of Gynecology and Obstetrics, Hospital Sanitas La Moraleja, 28050 Madrid, Spain
| | - Mario Prieto
- Department of Pathology, HM Hospitales, 28050 Madrid, Spain
| | | | | | - Nieves Escolán
- Department of Plastic Surgery, HM Hospitales, 28050 Madrid, Spain
| | - Beatriz Álvarez
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Xin Chen
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Rosa Alonso
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Mercedes López
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Ovidio Hernando
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Jeannette Valero
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Emilio Sánchez
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Eva Ciruelos
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
| | - Carmen Rubio
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
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Tu C, He Y, Ma X. Factors influencing psychological distress and effects of stepwise psychological care on quality of life in patients undergoing chemotherapy after breast cancer surgery. Am J Transl Res 2022; 14:1923-1933. [PMID: 35422923 PMCID: PMC8991156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/30/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate factors influencing psychological distress and the effect of stepwise psychological care on the quality of life in patients undergoing chemotherapy after breast cancer surgery. METHODS A retrospective study was conducted on 96 patients undergoing chemotherapy after breast cancer surgery. The patients were evenly divided into a routine care group (control group) and a stepwise psychological care group (observation group) according to the care method. The correlation between the psychological distress and the Self-Rating Anxiety Scale (SAS) score was investigated. The impact of care intervention on the psychological distress, SAS score, and the quality of life of patients before and after intervention were explored. Relevant factors that affect the psychological distress of patients undergoing chemotherapy after breast cancer surgery were also investigated. RESULTS A univariate analysis showed that age, residence, monthly income, education level, medical insurance status, occupation, surgery method, and anxiety score all contributed to the degree of psychological distress in patients with breast cancer mastectomy (all P<0.05). A multivariate regression analysis demonstrated that young age, low monthly income, no medical insurance, mastectomy, and high SAS score were risk factors for the psychological distress of patients who underwent mastectomy (all P<0.05). The psychological distress was positively correlated with anxiety scores of patients undergoing chemotherapy after breast cancer surgery (r=0.249, P=0.005). Both psychological distress and anxiety scores of the observation group after stepwise psychological care were significantly lower than those before treatment and those of the control group (both P<0.05). After treatment, both groups of patients showed better scores in additional concerning items, social/family well-being, functional well-being, physical well-being, emotional well-being, and overall quality of life than before treatment (all P<0.05). Of note, the observation group demonstrated better quality of life than that of the control group. CONCLUSION Age, low monthly income, radical mastectomy, and no medical insurance prior to undergoing chemotherapy after breast cancer surgery are independent factors that affect psychological distress. The distress was positively correlated with anxiety. Thus, stepwise psychological care may alleviate patients' psychological distress and anxiety.
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Affiliation(s)
- Congmei Tu
- Department of Hospice, Affiliated Hospital of Guangdong Medical University Zhanjiang 524001, Guangdong Province, China
| | - Yongping He
- Department of Hospice, Affiliated Hospital of Guangdong Medical University Zhanjiang 524001, Guangdong Province, China
| | - Xue Ma
- Department of Hospice, Affiliated Hospital of Guangdong Medical University Zhanjiang 524001, Guangdong Province, China
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Bellon JR, Chen YH, Rees R, Taghian AG, Wong JS, Punglia RS, Shiloh RY, Warren LE, Krishnan MS, Phillips J, Pretz J, Jimenez R, Macausland S, Pashtan I, Andrews C, Isakoff SJ, Winer EP, Tolaney SM. A Phase 1 Dose-Escalation Trial of Radiation Therapy and Concurrent Cisplatin for Stage II and III Triple-Negative Breast Cancer. Int J Radiat Oncol Biol Phys 2021; 111:45-52. [DOI: 10.1016/j.ijrobp.2021.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 01/29/2023]
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Haussmann J, Corradini S, Nestle-Kraemling C, Bölke E, Njanang FJD, Tamaskovics B, Orth K, Ruckhaeberle E, Fehm T, Mohrmann S, Simiantonakis I, Budach W, Matuschek C. Recent advances in radiotherapy of breast cancer. Radiat Oncol 2020; 15:71. [PMID: 32228654 PMCID: PMC7106718 DOI: 10.1186/s13014-020-01501-x] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/18/2020] [Indexed: 01/08/2023] Open
Abstract
Radiation therapy is an integral part of the multidisciplinary management of breast cancer. Regional lymph node irradiation in younger trials seems to provide superior target coverage as well as a reduction in long-term toxicity resulting in a small benefit in the overall survival rate. For partial breast irradiation there are now two large trials available which support the role of partial breast irradiation in low risk breast cancer patients. Multiple randomized trials have established that a sequentially applied dose to the tumor bed improves local control with the cost of worse cosmetic results.
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Affiliation(s)
- Jan Haussmann
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Carolin Nestle-Kraemling
- Department of Gynecologic and Obstetrics, Evanglisches Krankenhaus Dusseldorf, Dusseldorf, Germany
| | - Edwin Bölke
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany.
| | | | - Bálint Tamaskovics
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Klaus Orth
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Eugen Ruckhaeberle
- Department of Gynecology, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Tanja Fehm
- Department of Gynecology, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Svjetlana Mohrmann
- Department of Gynecology, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Ioannis Simiantonakis
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Wilfried Budach
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Christiane Matuschek
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
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