Breast Cancer Adjuvant Radiotherapy and Chemotherapy Sequencing: Sequential, Concomitant, or What Else? A Comprehensive Review on the Adjuvant Combinations Journey

Grazia Lazzari; Ilaria Benevento; Antonietta Montagna; Barbara D'Andrea; Antonella Bianculli; Giovanni Calice; Raffaele Tucciariello; Giovanni Castaldo; Vito Metallo; Angela Solazzo

doi:10.20944/preprints202409.0412.v1

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preprints.org > public health and healthcare > public health and health services > doi: 10.20944/preprints202409.0412.v1

Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Breast Cancer Adjuvant Radiotherapy and Chemotherapy Sequencing: Sequential, Concomitant, or What Else? A Comprehensive Review on the Adjuvant Combinations Journey

^* ,

Raffaele Tucciariello

Giovanni Castaldo

Vito Metallo

Angela Solazzo

Version 1 : Received: 4 September 2024 / Approved: 5 September 2024 / Online: 6 September 2024 (07:39:29 CEST)

How to cite: Lazzari, G.; Benevento, I.; Montagna, A.; D'Andrea, B.; Bianculli, A.; Calice, G.; Tucciariello, R.; Castaldo, G.; Metallo, V.; Solazzo, A. Breast Cancer Adjuvant Radiotherapy and Chemotherapy Sequencing: Sequential, Concomitant, or What Else? A Comprehensive Review on the Adjuvant Combinations Journey. Preprints 2024, 2024090412. https://doi.org/10.20944/preprints202409.0412.v1 Lazzari, G.; Benevento, I.; Montagna, A.; D'Andrea, B.; Bianculli, A.; Calice, G.; Tucciariello, R.; Castaldo, G.; Metallo, V.; Solazzo, A. Breast Cancer Adjuvant Radiotherapy and Chemotherapy Sequencing: Sequential, Concomitant, or What Else? A Comprehensive Review on the Adjuvant Combinations Journey. Preprints 2024, 2024090412. https://doi.org/10.20944/preprints202409.0412.v1

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MDPI and ACS Style

Lazzari, G.; Benevento, I.; Montagna, A.; D'Andrea, B.; Bianculli, A.; Calice, G.; Tucciariello, R.; Castaldo, G.; Metallo, V.; Solazzo, A. Breast Cancer Adjuvant Radiotherapy and Chemotherapy Sequencing: Sequential, Concomitant, or What Else? A Comprehensive Review on the Adjuvant Combinations Journey. Preprints 2024, 2024090412. https://doi.org/10.20944/preprints202409.0412.v1

APA Style

Lazzari, G., Benevento, I., Montagna, A., D'Andrea, B., Bianculli, A., Calice, G., Tucciariello, R., Castaldo, G., Metallo, V., & Solazzo, A. (2024). Breast Cancer Adjuvant Radiotherapy and Chemotherapy Sequencing: Sequential, Concomitant, or What Else? A Comprehensive Review on the Adjuvant Combinations Journey. Preprints. https://doi.org/10.20944/preprints202409.0412.v1

Chicago/Turabian Style

Lazzari, G., Vito Metallo and Angela Solazzo. 2024 "Breast Cancer Adjuvant Radiotherapy and Chemotherapy Sequencing: Sequential, Concomitant, or What Else? A Comprehensive Review on the Adjuvant Combinations Journey" Preprints. https://doi.org/10.20944/preprints202409.0412.v1

Abstract

Up to now in breast cancer (BC) treatment, adjuvant chemotherapy (A-CT) precedes adjuvant radiotherapy (A-RT). It’s beyond question that A-RT improves local control while A-CT improves the Disease Free Survival (DFS) due to the reduction of metastatic distant recurrences. Taken togheter these two approaches impact favourably on the reduction of breast cancer mortality. In the last twenty years, the adjuvant treatment of BC has evolved quickly due to a better knowledge of its molecular biology , genetic prohile and its α/β ratio 3 / 4 Gy for the tumor and normal tissues radiosensitivity. Thus new schedules with hypofractionated radiotherapy have been tested and third generation of A-CT have been introduced leading to a better survival rate but a further delay in A-RT starting, raising the question to rethink the sequencing between these two approaches. However the sequencing timing between these two approaches still remains unchanged with A-CT before A-RT as the standard of care. Many attempts have been provided in order to optimize this sequencing. This comprehensive review is a journey among randomised, retrospective and prospective studies which highlights the past, the current and the novelties on timing sequencing proposals between these two modalities to assess the state of art. Sequential, concomitant and sandwitch modalities of chemotherapy with conventional or hypofractionated RT schedules from the most important studies will be analysed in this review.

Keywords

adjuvant chemotherapy; radiotherapy; concomitant RT ; sequential RT; timing

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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