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Neoadjuvant chemotherapy for breast cancer—background for the indication of locoregional treatment

Neoadjuvante Chemotherapie bei Mammakarzinom – Grundlagen für die Indikation zur lokoregionären Behandlung

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Abstract

Neoadjuvant chemotherapy (NACT) has been widely adopted into the multidisciplinary management of breast cancer. The prognostic impact of treatment response has been clearly demonstrated. However, the impact of treatment response on the indication for adjuvant radiotherapy is unclear. This review summarizes important implications of NACT and treatment response on the risk of recurrence and locoregional multidisciplinary management from the standpoint of radiation oncology.

Zusammenfassung

Die neoadjuvante Chemotherapie (NACT) hat mittlerweile einen festen Stellenwert in der interdisziplinären Behandlung des Mammakarzinoms. Der prognostische Einfluss des Therapieansprechens konnte mehrfach klar gezeigt werden. Jedoch ist der Einfluss des Therapieansprechens auf die Indikation für die adjuvante Strahlentherapie noch weitgehend unklar. Diese Übersichtsarbeit fasst die wichtigen Auswirkungen der NACT und des Therapieansprechens auf das Rezidivrisiko und die lokoregionäre interdisziplinäre Behandlung aus der Sichtweise der Radioonkologie zusammen.

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Authors and Affiliations

  1. Department of Radiation Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    David Krug

  2. University Hospital Schleswig-Holstein, Kiel, Germany

    René Baumann & Jürgen Dunst

  3. Department of Radiation Oncology, University Hospital Düsseldorf, Düsseldorf, Germany

    Wilfried Budach

  4. Vivantes Hospital Neukölln, Berlin, Germany

    Petra Feyer

  5. University Hospital Erlangen, Erlangen, Germany

    Rainer Fietkau & Rolf Sauer

  6. Formerly St.-Vincentius-Hospital, Karlsruhe, Germany

    Wulf Haase

  7. St. Claraspital, Basel, Switzerland

    Wolfgang Harms

  8. Department of Radiation Oncology, Marienhospital Stuttgart, Stuttgart, Germany

    Thomas Hehr

  9. HELIOS-Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany

    Marc D. Piroth

  10. Paracelsus Medical University Hospital, Salzburg, Austria

    Felix Sedlmayer

  11. Formerly University Hospital Tuebingen, Tuebingen, Germany

    Rainer Souchon

  12. University Hospital Mannheim, Mannheim, Germany

    Frederik Wenz

  13. National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany

    David Krug

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  1. David Krug
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Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO)

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Correspondence to David Krug.

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Conflict of interest

D. Krug, R. Baumann, W. Budach, J. Dunst, P. Feyer, R. Fietkau, W. Haase, W. Harms, T. Hehr, M.D. Piroth, F. Sedlmayer, R. Souchon, F. Wenz, and R. Sauer declare that they have no competing interests.

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Krug, D., Baumann, R., Budach, W. et al. Neoadjuvant chemotherapy for breast cancer—background for the indication of locoregional treatment. Strahlenther Onkol 194, 797–805 (2018). https://doi.org/10.1007/s00066-018-1329-8

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