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000291985 1001_ $$aHaussmann, Jan$$b0
000291985 245__ $$aFactors influencing pathological complete response and tumor regression in neoadjuvant radiotherapy and chemotherapy for high-risk breast cancer.
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000291985 520__ $$aPathological complete response (pCR) is a well-established prognostic factor in breast cancer treated with neoadjuvant systemic therapy (naST). The determining factors of pCR are known to be intrinsic subtype, proliferation index, grading, clinical tumor and nodal stage as well as type of systemic therapy. The addition of neoadjuvant radiotherapy (naRT) to this paradigm might improve response, freedom from disease, toxicity and cosmetic outcome compared to adjuvant radiotherapy. The factors for pCR and primary tumor regression when neoadjuvant radiation therapy is added to chemotherapy have not been thoroughly described.We performed a retrospective analysis of 341 patients (cT1-cT4/cN0-N+) treated with naRT and naST between 1990 and 2003. Patients underwent naRT to the breast and mostly to the supra-/infraclavicular lymph nodes combined with an electron or brachytherapy boost. NaST was given either sequentially or simultaneously to naRT using different regimens. We used the univariate and multivariate regression analysis to estimate the effect of different subgroups and treatment modalities on pCR (ypT0/Tis and ypN0) as well as complete primary tumor response (ypT0/Tis; bpCR) in our cohort. Receiver operating characteristic (ROC) analysis was performed to evaluate the interval between radiotherapy (RT) and resection (Rx) as well as radiotherapy dose.Out of 341 patients, pCR and pbCR were achieved in 31% and 39%, respectively. pCR rate was influenced by resection type, breast cancer subtype, primary tumor stage and interval from radiation to surgery in the multivariate analysis. Univariate analysis of bpCR showed age, resection type, breast cancer subtype, clinical tumor stage and grading as significant factors. Resection type, subtype and clinical tumor stage remained significant in multivariate analysis. Radiation dose to the tumor and interval from radiation to surgery were not significant factors for pCR. However, when treatment factors were added to the model, a longer interval from radiotherapy to resection was a significant predictor for pCR.The factors associated with pCR following naST and naRT are similar to known factors after naST alone. Longer interval to surgery might to be associated with higher pCR rates. Dose escalation beyond 60 Gy did not result in higher response rates.
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000291985 650_7 $$2Other$$aBreast cancer
000291985 650_7 $$2Other$$aBreast response
000291985 650_7 $$2Other$$aNeoadjuvant chemotherapy
000291985 650_7 $$2Other$$aNeoadjuvant radiotherapy
000291985 650_7 $$2Other$$apCR
000291985 650_2 $$2MeSH$$aHumans
000291985 650_2 $$2MeSH$$aFemale
000291985 650_2 $$2MeSH$$aBreast Neoplasms: pathology
000291985 650_2 $$2MeSH$$aBreast Neoplasms: radiotherapy
000291985 650_2 $$2MeSH$$aBreast Neoplasms: therapy
000291985 650_2 $$2MeSH$$aNeoadjuvant Therapy
000291985 650_2 $$2MeSH$$aMiddle Aged
000291985 650_2 $$2MeSH$$aRetrospective Studies
000291985 650_2 $$2MeSH$$aAdult
000291985 650_2 $$2MeSH$$aAged
000291985 650_2 $$2MeSH$$aRadiotherapy, Adjuvant
000291985 650_2 $$2MeSH$$aPrognosis
000291985 650_2 $$2MeSH$$aAntineoplastic Combined Chemotherapy Protocols: therapeutic use
000291985 650_2 $$2MeSH$$aTreatment Outcome
000291985 650_2 $$2MeSH$$aROC Curve
000291985 7001_ $$aBudach, Wilfried$$b1
000291985 7001_ $$aNestle-Krämling, Carolin$$b2
000291985 7001_ $$aWollandt, Sylvia$$b3
000291985 7001_ $$aJazmati, Danny$$b4
000291985 7001_ $$aTamaskovics, Bálint$$b5
000291985 7001_ $$aCorradini, Stefanie$$b6
000291985 7001_ $$aBölke, Edwin$$b7
000291985 7001_ $$0P:(DE-He78)6911b891e4f82e142d099f0aa249c37d$$aHaussmann, Alexander$$b8$$udkfz
000291985 7001_ $$aAudretsch, Werner$$b9
000291985 7001_ $$aMatuschek, Christiane$$b10
000291985 773__ $$0PERI:(DE-600)2224965-5$$a10.1186/s13014-024-02450-5$$gVol. 19, no. 1, p. 99$$n1$$p99$$tRadiation oncology$$v19$$x1748-717X$$y2024
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