Reviewer: Neha Vapiwala, MD
The Abramson Cancer Center of the University of Pennsylvania
Ultima Vez Modificado: 30 de septiembre del 2005
Source: J Clin Oncol. 2005 Jan 1;23(1):11-6.
Authors: Harris EE, Christensen VJ, Hwang WT, Fox K, Solin LJ.
Affiliation: University of Pennsylvania, Philadelphia, PA.
The optimal sequencing of breast irradiation and adjuvant systemic therapy is controversial. A randomized trial evaluating the sequencing of radiation and cytotoxic chemotherapy trended toward more distant recurrence in patients treated with radiation first. A similar question exists regarding the sequencing of adjuvant hormonal therapy and radiation. Concurrent tamoxifen with radiation has been associated with more radiographic (but not clinical) findings of lung toxicity. Although tamoxifen can induce G1 arrest, a relatively radio-resistant phase of the cell cycle, experiments in cell culture have not consistently shown either a strong radio-protective or a radiosensitizing effect. Three retrospective studies examining sequencing of tamoxifen and radiation were published back-to-back in the Jan 2005 issue of J Clin Oncol.
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