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Preoperative Radiotherapy (Preop-RT) Improves Pathological Complete Response Rates in Partial Responders (PR) to
Sushma Agrawal1, Anshika Gupta1, Gyan Chand2
1Departments of Radiotherapy, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
South Asian Journal of Cancer
|December 25, 2025
Summary
Preoperative radiotherapy (preop-RT) shows promise in improving pathological complete response rates for locally advanced breast cancer. This pilot study in partial responders to chemotherapy yielded encouraging results, warranting further investigation in larger trials.
Area of Science:
- Oncology
- Radiation Oncology
- Breast Cancer Research
Background:
- Preoperative radiotherapy (preop-RT) is a strategy to enhance pathological complete response (pCR) in locally advanced breast cancer.
- This pilot study investigates the efficacy of preop-RT in patients with partial response to primary systemic chemotherapy (PST).
Purpose of the Study:
- To evaluate the pathological complete response (pCR) rates following preop-RT in partial responders to PST for locally advanced breast cancer.
- To assess the feasibility and outcomes of integrating preop-RT into the treatment of high-risk breast cancer patients.
Main Methods:
- Patients received standard PST (Adriamycin/cyclophosphamide followed by taxanes +/- trastuzumab).
- Partial responders underwent preop-RT (40 Gy/15# whole breast + 10 Gy/4# boost) followed by remaining taxane cycles.
- Surgery was performed 6 weeks after PST completion, aiming for a 12-week interval post-RT.
Main Results:
- Twenty-one women (median age 47) with high-risk features (e.g., T4, node-positive, TNBC) were enrolled.
- Pathological complete response rates were 53% for the tumor (ypCR(T)) and 59% for nodes (ypCR(N)).
- ypCR(T) rates varied by subtype: 50% for Her-2 positive, 25% for triple-negative breast cancer (TNBC), and 33.3% for luminal A.
Conclusions:
- This pilot study demonstrates encouraging pCR rates with preop-RT in high-risk breast cancer subsets.
- The findings suggest that preop-RT is a viable strategy that warrants further exploration in larger clinical trials.
