Skip to main content
Journal cover image

Post-mastectomy radiotherapy following adjuvant chemotherapy and autologous bone marrow transplantation for breast cancer patients with greater than or equal to 10 positive axillary lymph nodes. Cancer and Leukemia Group B.

Publication ,  Journal Article
Marks, LB; Halperin, EC; Prosnitz, LR; Ross, M; Vredenburgh, JJ; Rosner, GL; Peters, W
Published in: Int J Radiat Oncol Biol Phys
1992

Between 2/87 and 2/91, 49 women with operable breast cancer involving greater than or equal to 10 axillary nodes were treated following mastectomy, with four cycles of Cyclophosphamide, Adriamycin, 5FU, followed by high doses of Cyclophosphamide, Cisplatin, Carmustine (HDCT) with autologous bone marrow transplant support. Forty patients received local-regional radiotherapy (generally to the chest wall, internal mammary, supraclavicular, +/- axillary nodal areas; minimum 44-50 Gy, 1.8-2 Gy/fraction, +/- 10-15 Gy scar boost; standard radiation techniques). The first nine patients did not receive local-regional radiotherapy. Three developed a local-regional failure (6-12 months after HDCT); six are without evidence of disease. Local-regional radiotherapy (LR XRT) was delivered to the subsequent 40 patients following HDCT+autologous bone marrow transplant. Six received less than 44 Gy of the planned local-regional radiotherapy due to significant toxicity and one of these failed locally. Only one local failure was observed among the 34 patients who received greater than or equal to 44 Gy. Two additional patients developed distant metastases. None of these 40 patients have failed in the axilla despite the fact that the axilla was irradiated in only 18 cases. Overall, 36/40 (90%) of these patients are without evidence of disease 4-30 months following HDCT (approximately 10-36 months after mastectomy, median 22 months). Radiotherapy was interrupted or discontinued because of progressive dyspnea, thrombocytopenia, or neutropenia in nine patients. Further studies to determine the roles of local-regional radiotherapy and HDCT in the development of these toxicities are underway. These encouraging results suggest that HDCT + autologous bone marrow transplant+local-regional radiotherapy may improve the survival rate in these high risk patients. A national randomized study to test the efficacy of this HDCT regimen is currently underway (Cancer and Leukemia Group B#9082 and Southwest Oncology Group #9114).

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

1992

Volume

23

Issue

5

Start / End Page

1021 / 1026

Location

United States

Related Subject Headings

  • Transplantation, Autologous
  • Survival Rate
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Middle Aged
  • Mastectomy
  • Humans
  • Fluorouracil
  • Female
  • Doxorubicin
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Marks, L. B., Halperin, E. C., Prosnitz, L. R., Ross, M., Vredenburgh, J. J., Rosner, G. L., & Peters, W. (1992). Post-mastectomy radiotherapy following adjuvant chemotherapy and autologous bone marrow transplantation for breast cancer patients with greater than or equal to 10 positive axillary lymph nodes. Cancer and Leukemia Group B. Int J Radiat Oncol Biol Phys, 23(5), 1021–1026. https://doi.org/10.1016/0360-3016(92)90908-z
Marks, L. B., E. C. Halperin, L. R. Prosnitz, M. Ross, J. J. Vredenburgh, G. L. Rosner, and W. Peters. “Post-mastectomy radiotherapy following adjuvant chemotherapy and autologous bone marrow transplantation for breast cancer patients with greater than or equal to 10 positive axillary lymph nodes. Cancer and Leukemia Group B.Int J Radiat Oncol Biol Phys 23, no. 5 (1992): 1021–26. https://doi.org/10.1016/0360-3016(92)90908-z.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

1992

Volume

23

Issue

5

Start / End Page

1021 / 1026

Location

United States

Related Subject Headings

  • Transplantation, Autologous
  • Survival Rate
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Middle Aged
  • Mastectomy
  • Humans
  • Fluorouracil
  • Female
  • Doxorubicin