The results of radiation therapy for isolated local regional recurrence after mastectomy

Schwaibold, Frederick P.; Fowble, Barbara; Solin, Lawrence J.; Schultz, Delray; Goodman, Robert L.

doi:10.1016/0360-3016(91)90775-y

Cited by 165 publications

(82 citation statements)

References 36 publications

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“…Patients with local-regional recurrence after mastectomy have a poor prognosis; 5-year survival rates are routinely less than 50% [21,22]. Uncontrolled local-regional disease is highly morbid [3] and has been associated with worse survival (35% vs. 64% at 5 years) compared to those patients whose local-regional disease is controlled [23].…”

Section: Discussionmentioning

confidence: 99%

“…Uncontrolled local-regional disease is highly morbid [3] and has been associated with worse survival (35% vs. 64% at 5 years) compared to those patients whose local-regional disease is controlled [23]. Local control rates with radiation alone, the current standard of care, have been in the range of 30%-60% [1,4,21,[23][24]. Not surprisingly, several of these series suggested that tumors treated to higher radiation doses had improved local control [1,4,21,23].…”

Section: Discussionmentioning

confidence: 99%

“…Local control rates with radiation alone, the current standard of care, have been in the range of 30%-60% [1,4,21,[23][24]. Not surprisingly, several of these series suggested that tumors treated to higher radiation doses had improved local control [1,4,21,23]. However, improved local control comes at the risk of increased toxicity and wound healing complications [25], and it is often limited in the setting of prior irradiation.…”

Section: Discussionmentioning

confidence: 99%

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Phase I Study and Biomarker Analysis of Lapatinib and Concurrent Radiation for Locally Advanced Breast Cancer

et al. 2012

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Purpose. This phase I study assessed the toxicity and safety of combining daily lapatinib with radiation therapy. Sequential tumor biopsies were obtained to evaluate changes in biomarkers, such as epidermal growth factor receptor (EGFR) and human EGFR-2 (HER2) signaling pathways.Methods. Eligibility for this dose-escalation study included unresectable and locally recurrent or chemotherapyrefractory and locally advanced breast cancer, and adequate organ function. Patients underwent three serial biopsies: at baseline, after 1 week of lapatinib alone, and after 1 week of lapatinib and radiation. Endpoints included determination of toxicity, maximum tolerated dose, and analysis of the effect of lapatinib with or without radiation on EGFR and HER2 signaling pathways by immunohistochemistry.Results. Doses of lapatinib up to 1,500 mg/day were well tolerated. Toxicity of grade 3 or more was limited to radiation dermatitis and pain. Out of 19 patients treated, in field responses per Response Evaluation Criteria in Solid Tumors criteria were complete in four patients and partial in six patients. Serial biopsies were obtained in 16 patients with no complications. Total Her2 was relatively unchanged while phospho-Her2, phospho-Akt, and phospho-ERK showed variable responses to both lapatinib alone and dual therapy with lapatinib and radiation.Conclusions. The combination of lapatinib and radiation was well tolerated in this patient cohort. Overall local response rates were comparable to those reported in other studies in this patient population. Biopsies were safely performed at all time points. Inhibition of HER2 and downstream signaling pathways was identified, although no strong correlation with response was seen. The Oncologist

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Phase I Study and Biomarker Analysis of Lapatinib and Concurrent Radiation for Locally Advanced Breast Cancer

et al. 2012

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“…This treatment is necessary if the recurrence involves the TRAM flap pedicle. Excision alone for patients with LR after mastectomy is associated with failure rates of up to 75% [26]. Adjuvant radiation therapy to the residual TRAM flap or the chest wall is recommended.…”

Section: Discussionmentioning

confidence: 99%

Invasive Breast Cancer after Mastectomy and Autologous Breast Reconstruction

Zakaria

Herrick

Reynolds

et al. 2009

Scholarly Research Exchange

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Recurrence or new breast cancer after mastectomy and autologous breast reconstruction is a rare occurrence. We present a case series of four patients with this rare phenomenon and describe their presentation, workup, and surgical and adjuvant therapy. We discuss the possible physiologic mechanisms leading to tumor recurrence in a reconstructed breast along with literature review. A new palpable mass in a reconstructed breast mound warrants tissue diagnosis to avoid delay in treatment. The surgical options for breast cancer in tissue reconstructions depend on the location and extent of the tumor, involvement of the vascular pedicle, stage of disease, and adjuvant therapy options.

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“…[1][2][3][4][5][6][7] The early literature, which describes the outcomes of women with LRR following mastectomy, evaluated primarily local therapeutic options including either RT and/or surgical therapy. [8][9][10][11][12][13][14][15][16][17][18][19][20] The 5-year progression-free survival (PFS) and overall survival (OS) in these series ranged between 13-37% and 21-50%, respectively. However, since LRR following mastectomy is usually an initial manifestation of systemic disease, it is logical to combine systemic therapy with local treatment.…”

mentioning

confidence: 99%

Outcomes of high-dose chemotherapy and autologous stem cell transplant in isolated locally recurrent breast cancer: a multicenter evaluation

Vij

DiPersio

Brown

et al. 2000

Bone Marrow Transplant

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The results of radiation therapy for isolated local regional recurrence after mastectomy

Cited by 165 publications

References 36 publications

Phase I Study and Biomarker Analysis of Lapatinib and Concurrent Radiation for Locally Advanced Breast Cancer

Phase I Study and Biomarker Analysis of Lapatinib and Concurrent Radiation for Locally Advanced Breast Cancer

Invasive Breast Cancer after Mastectomy and Autologous Breast Reconstruction

Outcomes of high-dose chemotherapy and autologous stem cell transplant in isolated locally recurrent breast cancer: a multicenter evaluation

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