Preoperative radiotherapy: A paradigm shift in the treatment of breast cancer? A review of literature

Corradini, Stefanie; Krug, David; Meattini, Icro; Matuschek, Christiane; Bölke, Edwin; Baumann, René; Figlia, Vanessa; Pazos, Montserrat; Tonetto, Fabrizio; Trovò, Marco; Mazzola, Rosario; Alongi, Filippo

doi:10.1016/j.critrevonc.2019.06.003

Cited by 36 publications

(34 citation statements)

References 74 publications

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“…The notably worse DFS and OS of CSR group compared to the other two groups is presumably caused by potential development of fibrosis, as a result of the delayed surgery, may increase technical difficulties and surgical complications. Besides, longer interval between RCT and surgical resection may be associated with higher morbidity and more difficulties in surgical resection, which is consistent with the results of previous trials 17‐19 …”

Section: Discussionsupporting

confidence: 89%

“…This improvement of cosmesis in breast‐conservation therapy has been observed by several previous studies 13,17 . Here, we utilized self‐assessment method to evaluate cosmetic outcomes during 5‐year follow‐up period.…”

Section: Discussionmentioning

confidence: 62%

“…This reduction in fibrosis could be due to the efficient removal of regions that received the high radiation doses during surgery, therefore resulting in limited fibrosis. Our study is one of the few studies showing the benefit of preoperative radiotherapy in reducing the risk of fibrosis 17 . The notably worse DFS and OS of CSR group compared to the other two groups is presumably caused by potential development of fibrosis, as a result of the delayed surgery, may increase technical difficulties and surgical complications.…”

Section: Discussionmentioning

confidence: 68%

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Effect of sequencing of preoperative systemic therapy on patients with locally advanced breast cancer

XiChi

Zhou

et al. 2020

Breast J

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Background The study aims to perform a clinical trial to evaluate the effect of sequencing of systemic therapy on locally advanced breast cancer (LABC). Methods LABC patients (n = 733) underwent the combination of external beam radiation therapy, chemotherapy, and breast‐conservation surgery with difference sequences. Biopsy followed by histopathological examinations was used to assess treatment responses. The primary end point is ipsilateral local recurrence or death. The secondary end points include the incidence and severity of acute and late side effects, cosmesis, and cumulative incidence of regional recurrence and distant metastasis, and survival. The effects of sequence of therapies on the side effects and treatment outcomes were compared. Results Patients with preoperative systemic treatment, that is, chemotherapy and radiotherapy performed ahead of surgery, had less fibrosis and pain, and showed higher satisfaction regarding the breast conservation. Preoperative systemic treatment also led to better survival of the patients. Conclusions Preoperative systemic therapy is beneficial to alleviate side effects and improve the breast conservation, treatment outcome, and survival of LABC patients.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 68%

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Effect of sequencing of preoperative systemic therapy on patients with locally advanced breast cancer

XiChi

Zhou

et al. 2020

Breast J

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“…In the last few years, the treatment is improving due to new surgical techniques, new systemic therapeutic options and a better understanding of the biology of the disease [7][8][9]. Furthermore, there are also advances in the field of radiation oncology [10,11] ( Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

Recent advances in radiotherapy of breast cancer

et al. 2020

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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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“…If the sequence is preoperative radiotherapy ⟶ neoadjuvant chemotherapy (NACT) ⟶ operation, risks of complications of delayed surgery after operation will increase [ 15 ]. Postoperative treatment is also vital, which can not only significantly decrease the recurrence rate and mortality rate of breast cancer but also improve the life quality of breast cancer patients [ 16 – 18 ]. Related studies showed that for the total resection of lymph node negative diseases with limited size and whole-body risks, conducting partial breast irradiation after breast-conserving surgery could shorten the stages [ 19 , 20 ] and might have better beauty effects [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Low Expression of DDX60 Gene Might Associate with the Radiosensitivity for Patients with Breast Cancer

Xin

Liu

et al. 2020

Journal of Oncology

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DEXD/H box helicase 60 (DDX60) is a new type of DEAD-box RNA helicase, which is induced to express after virus infection. It might involve in antiviral immunity by promoting RIG-I-like receptor-mediated signal transduction. In addition, previous studies had shown that the expression of DDX60 is related to cancer, but there was still a lack of relevant research in breast cancer. In this study, we used the information of patients with breast cancer in the TCGA database for statistical analysis and found that the breast cancer patients with low expression of DDX60 exhibited radiosensitivity. Comparing the radiotherapy groups with the nonradiotherapy groups, for patients with low expression of DDX60, the adjusted hazard ratio (HR) values for radiotherapy were 0.244 (0.064–0.921) and 0.199 (0.062–0.646) in the training and validation datasets, with the p values 0.040 and 0.007, respectively. However, for patients with high expression of DDX60, the adjusted hazard ratio (HR) values were 3.582 (0.627–20.467) and 2.421 (0.460–12.773), with the p values 0.054 and 0.297, respectively. These results suggested that the expression of DDX60 might strongly associate with individualized radiosensitivity in patients with breast cancer.

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Preoperative radiotherapy: A paradigm shift in the treatment of breast cancer? A review of literature

Cited by 36 publications

References 74 publications

Effect of sequencing of preoperative systemic therapy on patients with locally advanced breast cancer

Effect of sequencing of preoperative systemic therapy on patients with locally advanced breast cancer

Recent advances in radiotherapy of breast cancer

Low Expression of DDX60 Gene Might Associate with the Radiosensitivity for Patients with Breast Cancer

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