Results of Concomitantly Administered Chemoradiation for Locally Advanced Noninflammatory Breast Cancer

Locally advanced breast cancer patients are a heterogeneous group with a wide range of prognoses. They require a multimodality approach to the treatment of their illness with the interdigitation of surgery, chemotherapy, and radiation therapy. Systemic, chemotherapy has gained widespread acceptance for the treatment of this disease. Three published randomized trials show an improvement in relapse-free survival with the administration of systemic therapy. In an effort to improve on these results, some investigators have chosen to administer systemic chemotherapy concomitantly with radiation therapy. The rationale is to capitalize on the radiosensitizing effects of some chemotherapueitc drugs to enhance effectiveness. Short-term toxicities have been minimal and tolerable. Lessons learned from the treatment of early-stage disease with concurrent therapy should keep long-term toxicities modest also. Concomitant therapy provides an attractive arean for clinical investigation, particularly with new agents such as taxol. In addition, concomitant radiation and chemotherapy have been used in approaches to achieve breast preservation as has been accomplished in early-stage disease. Locally advanced breast cancer provides an arena for the study of many innovative treatment methods.