Radiotherapy after breast-conserving surgery in small breast carcinoma: Long-term results of a randomized trial

• Published in: Annals of oncology Vol. 12; no. 7; pp. 997 - 1003
• Main Authors: Veronesi, U., Marubini, E., Mariani, L., Galimberti, V., Luini, A., Veronesi, P., Salvadori, B, Zucali, R.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.07.2001
• Subjects: Adult; Age Factors; Aged; Axilla; Biological and medical sciences; Breast Neoplasms - pathology; Breast Neoplasms - radiotherapy; Breast Neoplasms - surgery; breast-conserving surgery; Carcinoma - pathology; Carcinoma - radiotherapy; Carcinoma - surgery; Female; Follow-Up Studies; Humans; Lymphatic Metastasis; Mastectomy, Segmental; Medical sciences; Middle Aged; Neoplasm Recurrence, Local; Radiation therapy and radiosensitizing agent; radiotherapy; Radiotherapy, Adjuvant; small breast carcinooma; Survival Analysis; Treatment Outcome; Treatment with physical agents; Treatment. General aspects; Tumors; Antineoplastic agent; Human; Postoperative; Carcinoma; Resection; Treatment efficiency; Adjuvant treatment; Malignant tumor; Radiotherapy; Survival; Mammary gland diseases; Randomization; Conservative surgery; Treatment; Surgery; Clinical trial; Mammary gland
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1023/A:1011136326943

BackgroundThalidomide is effective in approximately 30% of patients with refractory multiple myeloma. Dexarnethasone is active in 25%of patients with disease resistant to alkylating agents. We investigated the combination of thalidomide with dexarneth treatment for heavily pretreated patients with multiple myeloma, in order to assess its efficacy and toxicity. Patients and methods: Forty-four patients with refractory myelorna were treated with thalidomide, 200 mg p.o. daily at bededtime, with dose escalation to 400 rng after 14 days, and dexarnethasone, which was administered intermittently at a dose of 20 mg/m2 p.o. daily for four days on day 1–4, 9–12, 17–20, followed by monthly dexamethasone for four days. Patients' median age was 67 years. All patients were resistant to standard chemotherapy, 77% were resistant to dexamethasone based regimens and 32% had previously received high-dose therapy. Results: On an intention-to-treat basis twenty-four patients (55%) achieved a partial response with a median time to response of 1.3 months. The thalidomide and dexamethasone combination was equally effective in patients with or without prior resistance to dexamethasone-based regimens and in patients with or without prior high-dose therapy. Toxicities were mild or moderate and consisted primarily of constipation, morning somnolence, tremor, xerostomia and peripheral neuro pathy. The median time to progression for responding patients is expected to exceed 10 months and the median survival for all patients is 12.6 months. Conclusion: The combination of thalidomide with dexa methasone appears active in patients with refractory multiple myeloma. If this activity is confirmed, further studies of this combination as second-line treatment for patients resistant to conventional chemotherapy, and as primary treatment for patients with active rnyeloma. should be considered.