Interaction of chemotherapy, radiotherapy, and timing

Abstract

New methods that have been developed to regulate and modify the biological response of tumors and of normal tissues to radiation to achieve maximum benefit with minimum harm to the adjacent normal tissues should be considered be among the most significant developments in radiotherapy (RT) in recent years. These methods include different fractionation schemes, the application of chemical and biological agents, and effective therapies targeted toward molecular pathway-signal transduction mechanisms. Among these treatment strategies, the most widely used method in clinical practice is the combination of chemotherapy (CT) with RT. Since the development of CT and RT, many studies have been published regarding adjuvant treatment of breast cancer, which remains a controversial issue. However, despite advances and innovations in breast cancer treatment, there is still no consensus on the optimal treatment approach, mainly because breast cancer is a heterogeneous group of diseases with a wide spectrum of biological behaviors. In this section, the molecular biological mechanisms of the interaction between RT and CT in breast cancer, as well as the optimal timing of RT and CT, will be discussed in light of relevant randomized trials. © Springer Science+Business Media New York 2013.