Optimising radiation treatment decisions for patients who

The lancet oncology · Jun 2012

Review

Optimising radiation treatment decisions for patients who receive neoadjuvant chemotherapy and mastectomy.

Whereas randomised clinical trials have established which patients might benefit from postmastectomy radiation therapy after upfront surgery, no such data exist for guiding decisions on who might benefit from postmastectomy radiation therapy after upfront chemotherapy. Insight must be drawn from non-randomised data to provide such guidance. Early data suggest that both extent of disease at presentation and response to neoadjuvant chemotherapy predict the risk of locoregional recurrence, and can be used to tailor recommendations for postmastectomy radiation therapy. Randomised clinical trial data are needed to assess whether postmastectomy radiation therapy can be safely omitted in selected women with good response to neoadjuvant chemotherapy.

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- Karen E Hoffman, Elizabeth A Mittendorf, and Thomas A Buchholz.
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. khoffman1@mdanderson.org
- Lancet Oncol. 2012 Jun 1; 13 (6): e270-6.
AbstractWhereas randomised clinical trials have established which patients might benefit from postmastectomy radiation therapy after upfront surgery, no such data exist for guiding decisions on who might benefit from postmastectomy radiation therapy after upfront chemotherapy. Insight must be drawn from non-randomised data to provide such guidance. Early data suggest that both extent of disease at presentation and response to neoadjuvant chemotherapy predict the risk of locoregional recurrence, and can be used to tailor recommendations for postmastectomy radiation therapy. Randomised clinical trial data are needed to assess whether postmastectomy radiation therapy can be safely omitted in selected women with good response to neoadjuvant chemotherapy.Copyright © 2012 Elsevier Ltd. All rights reserved.

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Optimising radiation treatment decisions for patients who receive neoadjuvant chemotherapy and mastectomy.

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