Download The comparison between neo-adjuvant chemotherapy and

Comparison between neo-adjuvant chemotherapy and
radiotherapy in locally advanced breast cancer
Purnagari A, Melvina M. Padjadjaran University Medical Faculty. Bandung, Indonesia
Introduction
Breast cancer is the second most common cancer in Indonesia. Social, economic, and
cultural factors in Indonesia have led patients not to acknowledge the disease and seek
treatment in the early stages of breast cancer. Thus, many breast cancer patients in
Bandung are diagnosed with Locally Advanced Breast Cancer. Locally Advanced
Breast Cancer (LABC), which in general has been defined as stage III in the AJCC
system, has a 5-year survival rate of less than 30%-40%. It has the characteristics of
both local and advanced cancer. The initial treatments for LABC are neo-adjuvant
chemotherapy or radiotherapy.
Aim
There is still a controversy in choosing the best initial treatment for LABC. The aim of
this study is to compare neo-adjuvant chemotherapy and radiotherapy in LABC.
Method
Randomized clinical trial. Comparing the response, local recurrence, and metastases of
30 LABC patients that have been treated with neo-adjuvant chemotherapy and 30
LABC patients that have been treated with radiation before surgery in dr.Hasan Sadikin
Hospital (RSHS), Bandung, Indonesia within the period of 2003-2006.
Results
In the 30 LABC patients treated with neo-adjuvant chemotherapy, 10% are not
responsive, 50% are partially responsive, and 40% are totally responsive. Metastases
after three cycles of chemotherapy are not found. In the 30 LABC patients treated with
radiation, one third are not responsive, one third are partially responsive, and one third
are totally responsive. Metastases were found after 15 radiations to the lung (50%) and
liver (10%).
Discussion
Concluding: neo-adjuvant chemotherapy is the best choice for initial treatment.
However, the cost of this treatment is far more expensive than radiotherapy. Therefore
in Indonesia, a developing country with a low Gross Domestic Product (GDP),
radiotherapy is given more often.
Further Reading
* Donegan and Spratt: Cancer of The
Breast. Fifth edition. Saunders, Missouri.
2002. p579-589, 639-684
* Hortobagyi GN. Treatment of Breast
Cancer. In www.nejm.org accessed on
April, 14 2006
* Soemitro M. Randomized clinical trial in
RSHS within the period of 2003-2006
Summer School Participants
Arum Purnagari
Bandung. [email protected]
&
Meta Melvina
Bandung [email protected]
Acknowledgements
We would like to thank: Professor F.F.
Wirakusumah, gynecologist and our faculty;
Dr. Monty Soemitro, surgical oncologist
and his staff; The Dutch Cancer Foundation
for financial support; Our families and
friends for giving us all their support.