الفهرس 
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Abstract
The standard treatment for localized breast cancer is breast conservative surgery followed by radiotherapy to the breast possibly combined with a boost to the tumour bed, or mastectomy when a large tumour prevents breast-conserving treatment. This strategy reduces the risk of local recurrence and improves the patient’s overall survival. Avoiding mastectomy is an essential goal for patients in terms of quality of life.
Almost all patients treated with BCS are recommended to receive radiotherapy, whereas in patients treated with mastectomy, radiotherapy is reserved for those at high risk. There is little dispute on the sequence of chemotherapy and radiotherapy in patients treated with mastectomy: chemotherapy followed by radiotherapy is commonly used in practice.
Previous reports found conflicting results: some studies found that delaying the initiation of radiotherapy after BCS led to an increased risk of local failure while others showed that radiotherapy started after the completion of chemotherapy but within 7 months after surgery did not affect tumor control or survival.
The current study conducted at South Egypt Cancer Institute, Assiut University, Egypt. The study was conducted in the period between May 2014 and December 2021. A total of 46 patients were enrolled in the study. The study aimed to evaluate the efficacy, safety and efficacy of concurrent paclitaxel and breast radiotherapy.
Mean age of enrolled women was 47.26 ± 11.39 and ranged from 28 up to 70 years old and majority (65.2%) were aged less than 50 years. The majority of the studied cases had infiltrating duct carcinoma which documented in 43 cases (93.5%). Thirty-one patient (67.4%) had stage and 15 patients (32.6%) had stage Thirty-six (78.3%) had positive hormonal receptors, 10 (21.7%) had negative hormone receptor and 8 (17.4%) patients with her2 over expression.
The main findings in the current study were that during the follow up period, two cases (4.3%) developed loco-regional recurrence (one case at the operative bed, and the other case at the regional lymph nodes), while four cases (8.7%) developed distant metastasis (two cases developed lung metastasis, one case developed bone metastasis, and another case developed liver metastasis). We found that tumor grade-1 and stage 1 and nodal stage 1 had the higher overall survival and disease free survival in comparison to other grades.
The median follow-up duration of the 46 breast cancer patients was 61 months (range, 30 to 68 months). During follow-up, 4/46 patients (8.7%) died as a result of tumor progression. Overall survival rate was 89.0%. A total of 6/46 patients (13.0%) developed disease progression. The median time to progression was 61 months (range, 24 to 68 months). disease free survival rate after 68 months was 86.6%. As regard safety of this regimen, we found that this regimen had great margin of safety with less toxic effects as regard skin, cardiac, pulmonary toxicity.
In conclusion; the study confirmed a wide safety profile of paclitaxel if was given concurrently during radiotherapy in the adjuvant setting after breast-conserving surgery with excellent local control, acceptable tolerability, pulmonary and skin complications in addition to acceptable cosmoses without delay of radiation. Future studies on large number of patients in multiple centers with longer duration of follow up should be done.