Abstract ES6-3: ES6-3 Radiation implications post neoadjuvant therapy

Neoadjuvant therapy offers unique challenges and opportunities for the radiation oncologist. Classical indications for radiation have been rooted in the pathologic analysis of tissue resected prior to treating the patient with systemic therapy. However, in patients treated with neoadjuvant therapy, pathologic findings are frequently altered by the administration of systemic therapy, and thus classical indications for radiation may be clouded. Nevertheless, the degree of response to neoadjuvant therapy offers a novel prognostic factor which reflects intrinsic tumor biology and affords the opportunity for a new, precision approach to risk stratification and radiation therapy treatment decision making.To maximally capitalize on the information gained from treating a patient with neoadjuvant chemotherapy, patients must be meticulously staged, preferably by a multidisciplinary team, prior to initiation of systemic therapy. Ultrasound of the regional nodal basins including the low axillary, infraclavicular, supraclavicular, and internal mammary nodal chains with ultrasound-guided fine needle aspiration of radiographically abnormal nodes enables detailed mapping of the local-regional disease extent. Cross-sectional imaging with CT and/or PET/CT is also helpful to permit customized radiation field design after systemic therapy and surgery. These imaging studies are invaluable to the radiation oncologist and allow for optimal field design to facilitate cure. Additionally, nodal surger...

Source: Cancer Research - February 13, 2017 Category: Cancer & Oncology Authors: BD Smith Tags: Invited Speaker Abstracts Source Type: research