Management of non-resectable (stage III) breast cancer

Abstract

Thirteen patients with stage T3b or T4 breast carcinoma were treated with radiation and chemotherapy. The radiation therapy (RT) was given to the involved breast and adjacent nodal areas to a dose of 7000–9000 rad over 8–10 weeks. The chemotherapy consisted of cyclophosphamide 150 mg/m 2 and SFU 300 mg/m 2 IV days 1–5 repeated every 5 weeks and Prednisone 10 mg PO qd (CFP). All patients received 12 cycles of chemotherapy—6 patients began CFP within one month of completion of RT and 6 received CFP and RT simultaneously. Characteristics of the patients were: mean age 57, menopausal status—4 pre and 8 post with a mean years posmenopausal of 10. All patients had only evidence of localized disease. Eleven of the 13 patients remain in complete remission with a median duration of complete response of 38+ months. One patient receiving simultaneous CFP and RT relapsed after completion of RT. One patient receiving simultaneous CFP and RT relapsed 2 months after completion of CFP. Local skin toxicity from radiation was significantly greater in those receiving simultaneous CFP and RT. The role of radiation therapy combined with chemotherapy in the management of Stage III breast carcinoma is suggested and this will be explored further in an ECOG cooperative group trial.