Management of locally advanced carcinoma of the breast by primary radiation therapy and chemotherapy

One hundred and sixty-four patients with non-inflammatory stage III breast cancer were treated at the Hospital de la Santa Creu i Sant Pau in Barcelona (Spain) between December 1977 and January 1987. Fifty-six patients were treated with radical radiation therapy alone, 45 patients with radiation therapy and simultaneous chemotherapy (CMF), and 63 patients received radiation therapy and sequential chemotherapy (adriamycin and cyclosphosphamide) with or without hormonotherapy. The 5-year rate of overall survival was 53.3. The 5-year rate of local tumor control was 53, and the 5-year rate of survival free distant failure was 43.5. Multivariate analysis identified three factors significantly related to survival: positive estrogenic receptors (P = 0.01), tumor localisation (P = 0.01), and tumor response at the end of treatment (P = 0.0005). In our series, neither the T stage nor the use of adjuvant systemic therapy were significantly related to survival and local control. Esthetic appearance was judged to be excellent in 58 patients (35.3%). The results suggest that primary radiation therapy with or without systemic therapy (chemotherapy and/or hormonotherapy) can locally control advanced breast cancer in a consistent fashion without casing significant mobidity.