The risk of local recurrence was 16-29% among the patients with close, positive, or indeterminate margins who did not receive systemic therapy or who received radiation after completion of chemotherapy.
Patients in the NSABP B-31, N9831, and BCIRG-006 trials received adjuvant radiation upon completion of chemotherapy during maintenance trastuzumab.
Thirty three patients received planned chemotherapy immediately (less than one month after radiation therapy completion), and six patients received the combination chemotherapy as a salvage treatment after WBRT failure.
The CPT-11 dose intensity in that study was low because of the need to skip CPT-11 administration of days 8 and/or 15 as a result of leukopenia or diarrhoea, and the radiation therapy completion rate was low as well.
As the CPT-11 dose intensity in this trial was low, because of the necessity of omitting CPT-11 administration on days 8 and/or 15 as a result of leucopenia or diarrhoea, and the low radiation therapy completion rate, the trial was discontinued at level 2. Five patients at level 1 and three at level 2 showed partial responses, an overall response rate of 67%.
These patients experienced only mild localised lung damage in the radiation field after completion of full-dose TRT.
Patients who underwent radical lobectomy compared to those who received completion radiation up to 61 Gy showed a better long term overall survival [ 38].
The duration of time to locoregional failure and distant metastasis was measured from the date of the completion of radiation therapy (including boost irradiation) until documented treatment failure.
On diagnosis of breast cancer in RM specimens, a varying range of management has been reported, including observation only, tamoxifen alone (Cook and Fuller, 2004), completion mastectomy, radiation therapy (Clark et al, 2009) or a combination of radiation therapy and tamoxifen (Ishag et al, 2003).
In the case of grade 3 4 neutropenia or thrombocytopenia, complete blood counts were performed twice a week until recovery to ⩽grade 2. The clinical follow-up (as described above) was then performed every 2 weeks with complete blood counts assessed weekly and up to 8 weeks after completion of radiation therapy.
