Abbas Hamza, Elyamany Ashraf, Salem Mohamed, Salem Ahmed, Binziad Salah, Gamal Basem
Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Egypt.
Int Arch Med. 2011 Oct 16;4(1):35. doi: 10.1186/1755-7682-4-35.
The optimal time sequences for chemotherapy and radiation therapy after breast surgery for patients with breast cancer remains unknown. Most of published studies were done for early breast cancer patients. However, in Egypt advanced stages were the common presentation. This retrospective analysis aimed to assess the optimum sequence for our population.
267 eligible patients planned to receive adjuvant chemotherapy [FAC] and radiotherapy. Majority of patients (87.6%) underwent modified radical mastectomy while, 12.4% had conservative surgery.We divided the patients into 3 groups according to the sequence of chemotherapy and radiotherapy. Sixty-seven patients (25.1%) received postoperative radiotherapy before chemotherapy [group A]. One hundred and fifty patients (56.2%) were treated in a sandwich scheme (group B), which means that 3 chemotherapy cycles were given prior to radiotherapy followed by 3 further chemotherapy cycles. A group of 50 patients (18.7%) was treated sequentially (group C), which means that radiotherapy was supplied after finishing the last chemotherapy cycle. Patients' characteristics are balanced between different groups.
Disease free survival was estimated at 2.5 years, and it was 83.5%, 82.3% and 80% for patient receiving radiation before chemotherapy [group A], sandwich [group B] and after finishing chemotherapy [group C] respectively (p > 0.5). Grade 2 pneumonitis, which necessitates treatment with steroid, was detected in 3.4% of our patients, while grade 2 radiation dermatitis was 17.6%. There are no clinical significant differences between different groups regarded pulmonary or skin toxicities.
Regarding disease free survival and treatment toxicities, in our study, we did not find any significant difference between the different radiotherapy and chemotherapy sequences.
乳腺癌患者乳房手术后化疗和放疗的最佳时间顺序尚不清楚。大多数已发表的研究是针对早期乳腺癌患者进行的。然而，在埃及，晚期是常见的表现形式。这项回顾性分析旨在评估我们人群的最佳顺序。
267例符合条件的患者计划接受辅助化疗[FAC]和放疗。大多数患者（87.6%）接受了改良根治性乳房切除术，而12.4%接受了保乳手术。我们根据化疗和放疗的顺序将患者分为3组。67例患者（25.1%）在化疗前接受术后放疗[组A]。150例患者（56.2%）采用夹心方案治疗（组B），即放疗前给予3个化疗周期，随后再给予3个化疗周期。一组50例患者（18.7%）接受序贯治疗（组C），即最后一个化疗周期结束后进行放疗。不同组之间患者的特征是均衡的。
无病生存期估计为2.5年，化疗前接受放疗的患者[组A]、夹心方案治疗的患者[组B]和化疗结束后接受放疗的患者[组C]的无病生存率分别为83.5%、82.3%和80%（p>0.5）。3.4%的患者检测到需要用类固醇治疗的2级肺炎，而2级放射性皮炎为17.6%。在肺部或皮肤毒性方面，不同组之间没有临床显著差异。
关于无病生存期和治疗毒性，在我们的研究中，我们没有发现不同放疗和化疗顺序之间有任何显著差异。
