Table 2.
Studies of preoperative chemo-radiotherapy published to date.
| Author | n | Type of Study | Preoperative Radiotherapy |
Preoperative Systemic Treatment |
pCR (%) | Acute Toxicity |
Postoperative Complications | DFS (%) | OS (%) | MFU (Months) |
|---|---|---|---|---|---|---|---|---|---|---|
| Semiglazov 1994 [23] | 137 | Prospective | 60 Gy (2 Gy) WBI, 40 Gy (2 Gy) RNI | TMF | pCR: 29% | G1-2: 6.5% | 20% | 5y: 81 | 5y: 86 | 53 |
| Skinner, 1997 [34] |
35 | Prospective | 50 Gy (2 Gy) WBI + RNI | Pre-RT: F → Concurrent: F | pCR: 17% | NR | NR | 2y: 83 | 2y: 90 | 22 |
| Touboul 1997 [35] | 97 | Prospective | 46 Gy (2 Gy) WBI + RNI | Sequential: CAF-V × 4 | pCR: 40% | NR | NR | 10y: 60 | 10y: 66 | 94 |
| Colleoni 1998 [36] | 29 | Prospective | 50 Gy (2 Gy) WBI + boost to tumor nodule (10 Gy) | Sequential: AC × 3 | pCR: 6% | NR | NR | NS | NS | NS |
| Skinner2000 [37] | 28 | Prospective | 45 Gy (1.8 Gy) WBI + RNI | Concurrent: TAX × 8 | pCR:26% | NR | 41% | NS | NS | NS |
| Aryus 2000 [38] | 56 | Prospective | 50 Gy (2 Gy) WBI/RNI + boost tumor | Sequential: CMF or EC | pCR: 43% | NR | NR | NS | NS | NS |
| Formenti 2003 [39] | 44 | Prospective | 45–46 Gy (1.8–2 Gy) WBI + RNI | Pre-RT: dTAX → Concurrent: dTAX | pCR 34% | G2: 45% G3: 7% |
NR | 3y: 75.6 | 3y: 94 | 32 |
| Gerlach 2003 [40] | 134 | Retrospective | 50 Gy (2 Gy) WBI/RNI | Sequential: EC + CMF (n = 50) or EC | pCR: 42% | NENR | NR | NS | NS | 19 |
| Lerouge 2004 [41] | 120 | Prospective | 46 Gy (2 Gy) WBI + RNI | Sequential CAF-V × 4 or C-THP-F-Vd | pCR: 35% | NR | NR | 10y: 61 | 10y: 66.5 | 140 |
| Chakravarthy 2006 [42] |
38 | Prospective | 45 Gy (1.8 Gy) WBI + RNI | Pre-RT: TAX → Concurrent: TAX | pCR: 34% | G3: 2.6% G4: 2.6% |
10% | NS | NS | 23 |
| Bollet 2006 [43] 2012 [44] |
60 | Prospective | 50 Gy (2 Gy) WBI ± boost 10 Gy;46 Gy (2 Gy) RNI | Concurrent: FVb × 6 | pCR: 27% | G2: 19% G3: 14% |
12% | 83 | 88 | 84 |
| Gaui 2007 [45] | 28 | Retrospective | 50 Gy (2 Gy) WBI + RNI | Concurrent: Capecitabine | pCR: 4.3% | G1: 35% G2: 11% |
4% | NS | NS | NS |
| Shanta 2008 [46] | 1117 | Retrospective | 40 Gy (2 Gy) WBI + RNI | Concurrent: CMF/ECF/FAC | pCR: 45.1% | NR | 5.8% | 52.6 | 63.9 | NS |
| Alvarado- Miranda 2009 [47] |
112 | Retrospective | 50 Gy (2 Gy) WBI + RNI + boost 10 Gy | Concurrent: McF or cDDP-GMZ | pCR: 29.5% | G3: 22.4% | 17% | 76.9 | 84.2 | 43 |
| Adams 2010 [48] |
105 | Pooled analysis from three prospective trials, including Bollet 2006 and Formenti2003 | 45 Gy (1.8 Gy) WBI + RNI ± boost 14 Gy | Concurrent: TAX +/− Trastuzumab |
pCR: 23% | NR | NR | 61.4 | 71.6 | 60 |
| Monrigal 2011 [49] | 210 | Retrospective | 50 Gy (2 Gy) WBI + RNI + boost 10 Gy | Concurrent: Anthracyclin-based CT ± TAX ± Trastuzumab | pCR: 35.2% | NR | 26% | 5y:75.6 | 5y: 86.7 | 120 |
| Daveau 2011 [50] | 165 | Retrospective | 45 Gy (1.8 Gy) WBI + RNI + boost to tumor nodule (10–15 Gy) | Sequential: CAF or AdTAX × 6 cycles | pCR: 41% | NR | NR | 65 | 91 | NS |
| Ho 2012 [33] | 120 | Retrospective | 50 Gy (2 Gy) (60%) or 42.5 Gy (2.67 Gy) (40%)WBI/RNI; Boost (median dose 6.25 Gy) | Sequential: AC (n = 1); CMF (n s = 6); FEC (n = 4); A-TAX (n = 15); | pCR: NE | NR | 37% | 5y: 65 | 5y: 68 | 42 |
| Zinzindohoue 2016 [51] | 83 | Prospective | 50 Gy (2 Gy) WBI + RNI | Sequential: A-TAX | pCR: 36% | NR | 6% | 2y: 68 | NS | 24 |
| Brackstone 2017 [52] | 32 | Prospective | 45 Gy (1.8 Gy) WBI + RNI ± boost 5.4 Gy | Pre-RT: FEC → Concurrent: dTAX | pCR: 22.6% | G3: 25% | 3% | 3y: 81 | 3y: 89 | 36 |
| Pazos 2017 [53] | 22 | Retrospective | 50.4 Gy (1.8 Gy) WBI + RNI | Sequential: EC → TAX | pCR: 5% | NR | 25% | 30 months: 18 | 30 months: 18 | 30 |
| Haussmann 2022 [54] | 356 | Retrospective | 50 Gy (2 Gy) WBI + RNI + boost 10 Gy | Sequential: EC/CMF/AC/Mitoxantrone 61% or Concurrent: 36% or No CHT: 3% | pCR: 31.1% | NR | NR | NS | 10y: 69.7; 20y: 53.1 | 240 |
| Ciérvide 2022 [32] | 58 | Prospective | 40.5 Gy (2.7 Gy) WBI + RNI + SIB 54 Gy (3.6 Gy) | Concurrent: Pertuzumab-Trastuzumab-TAX → AC in HER2+ Concurrent: CBDCA-TAX → AC in TNBC | TN: 71% HER2+ 53% HR+: 48% HR−: 64% |
G1: 78% G2: 14% G3: 5% | 16% | 100 | 96.5 | 24 |
MFU: median follow-up; TMF: thiotepa-methrotexate-5Fluoracil; CAF-V: cyclophosphamide-adriamycin-5Fluoracil-vincristine; AC: adriamycin-cyclophosphamide; F: 5Fluoracil; TAX: paclitaxel; C-THP-F-Vd: cyclophosphamide-tepirubicin-5fluoracil-vindesine; CMF: cyclophosphamide-methrotexate-5fluoracil; Mc: mitomycin-C; cDDP: cisplatin; GMZ: gemcitabine; EC: epirubicin-cyclophosphamide; A-dTAX: adriamycin-docetaxel; FVb: 5fluoracil-vinorelbine; AI: aromatase inhibitor; A-TAX: adriamycin-paclitaxel; NR: not reported; NS: not specified.