Neoadjuvant Chemotherapy

Chemo Secrets From a Breast Cancer Survivor

Breast Cancer Survivors

Get Instant Access

A number of regimens have evolved in an effort to reduce treatment-related morbidity. Most current regimens are variations of combination chemotherapy regimens consisting of cis-platinum, 5-fluorouracil, and other agents used in conjunction with radiation therapy designed to take advantage of the radio-sensitizing properties of cis-DDP and 5-FU. A typical regimen involves 3 cycles of cis-DDP and 5-FU, with radiation therapy timed to begin at the initiation of chemotherapy and continued to a total dose of 4000-4500 cGy. The surgery is timed to allow complete recovery from the neutropenia of chemotherapy, which is usually 3-6 weeks after the last chemotherapy cycle. Although it is assumed that delays beyond 8 weeks will lead to technical difficulties with the surgery, the onset of fibrosis is variable and longer delays due to morbidity of the neoadjuvant treatment occasionally require that surgery be postponed beyond the 6-week ideal. The effectiveness of treatment

Fig. 6.3. The position of the gastric or colonic conduit after esophagogastrectomy (A). The conduit is either in the retrosternal position (B), or the posterior mediastinal position in the bed of the esophagus (C). The posterior mediastinal position may provide 2 cm or more of additional length to reach the neck compared with the substernal position.

Fig. 6.3. The position of the gastric or colonic conduit after esophagogastrectomy (A). The conduit is either in the retrosternal position (B), or the posterior mediastinal position in the bed of the esophagus (C). The posterior mediastinal position may provide 2 cm or more of additional length to reach the neck compared with the substernal position.

can be assessed in the operative specimen and chemotherapy continued for two additional postoperative cycles.

Was this article helpful?

0 0

Post a comment