Document Detail

MRI evaluation of neoadjuvant low-dose fractionated radiotherapy with concurrent chemotherapy in patients with locally advanced breast cancer.
MedLine Citation:
PMID:  22763034     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We address the diagnostic performance of breast MRI and the efficacy of neoadjuvant radiochemotherapy (NRC) treatment (NRC protocol) vs conventional neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer.
METHODS: The NRC protocol consists of six anthracycline/taxane cycles and concomitant low-dose radiotherapy on breast tumour volume. Breast MRI was performed at baseline and after the last therapy cycle in 18 and 36 patients undergoing the NRC protocol or conventional NAC (propensity matching).
RESULTS: In both groups, we observed reduced tumour dimensions after the last cycle (p<0.001), and the response evaluation criteria in solid tumours (RECIST) class directly correlated with the tumour regression grade class after the last cycle (p<0.001). Patients in the NRC group displayed a higher frequency of complete/partial response than those in the NAC group (p=0.034). 17 out of 18 patients in the NRC group met the criteria for avoiding mastectomy based on final MRI evaluation. The RECIST classification displayed a superior diagnostic performance in the prediction of the response to treatment [area under the receiver operating characteristic curve (AUC)=0.72] than time-to-intensity curves and apparent diffusion coefficient (AUC 0.63 and 0.61). The association of the three above criteria yielded a better diagnostic performance, both in the general population (AUC=0.79) and in the NRC and the NAC group separately (AUC=0.82 and AUC=0.76).
CONCLUSIONS: The pathological response is predicted by MRI performed after the last cycle, if both conventional MRI and diffusion imaging are integrated. The NRC treatment yields oncological results superior to NAC. Advances in knowledge MRI could be used to establish the neoadjuvant protocol in breast cancer patients.
E Bufi; P Belli; M Costantini; P Rinaldi; M Di Matteo; A Bonatesta; M C De Santis; L Nardone; D Terribile; A Mulé; L Bonomo
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Publication Detail:
Type:  Journal Article     Date:  2012-07-04
Journal Detail:
Title:  The British journal of radiology     Volume:  85     ISSN:  1748-880X     ISO Abbreviation:  Br J Radiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-23     Completed Date:  2013-01-04     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  0373125     Medline TA:  Br J Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  e995-1103     Citation Subset:  AIM; IM    
Department of Bioimaging and Radiological Sciences, Catholic University, Rome, Italy.
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MeSH Terms
Antineoplastic Agents / administration & dosage,  therapeutic use
Breast / pathology
Breast Neoplasms / pathology,  therapy*
Carcinoma, Ductal, Breast / pathology,  therapy
Clinical Protocols
Combined Modality Therapy
Diffusion Magnetic Resonance Imaging / methods
Doxorubicin / administration & dosage,  therapeutic use
Magnetic Resonance Imaging* / methods
Middle Aged
Neoadjuvant Therapy / methods
Taxoids / administration & dosage,  therapeutic use
Reg. No./Substance:
0/Antineoplastic Agents; 0/Taxoids; 15H5577CQD/docetaxel; 23214-92-8/Doxorubicin

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