Radiation with concomitant chemotherapy after surgery for breast carcinoma

In breast cancer postoperative radiation therapy improves local control rate and survival. When chemotherapy and radiation are indicated, the sequencing of the two treatments is still controversial. Several studies have suggested that adjuvant radiotherapy could be safely delayed until adjuvant chemotherapy was completed. Other studies, most of them retrospective, pointed out that a delay in the initiation of radiotherapy in order to give chemotherapy first may result in an increased rate of local recurrence. Concomitant administration of the two treatments is an attractive alternative. Pilot studies have demonstrated id feasibility. A randomized phase III trial is presently in progress, comparing sequential treatment with chemotherapy first followed by irradiation and radiation versus concomitant treatment. Four-hundred and five patients have been included in 24 months. Toxicity and compliance to the treatment are reported in this evaluation. (author)