In which of the following, neo-adjuvant chemotherapy is not used?
Ans. c. Breast cancer stage 2 (Ref: Schwartz 9/e p454-457; Sabiston 19/e p858-864; Bailey 25/e p841-842; Devita 9/e)Neoadjuvant chemotherapy is given in LABC (Stage IIIA, IIIB, IIIC) but not in Breast cancer stage II. Adjuvant chemotherapy can be given in Breast cancer stage II.Breast Cancer TreatmentEarly Invasive Breast Cancer (Stage I, IIA, IIB):Mastectomy + Axillary LN status assessmentQ orBCT + Axillary LN status assessment + RTQIf sentinel LN cannot be identified or found to harbor metastatic disease, axillary LN dissection (Level l+II) should be doneLocally Advanced Breast Cancer (Stage IIIA, IIIB, IIIC)Q:Neoadjuvant chemotherapy + MRM + Adjuvant RTQBCT for IIIA with N1 with patients who achieve good response to neoadjuvant chemotherapyQSystemic chemotherapy + radiotherapy are indicated in treatment of grossly involved internal mammary nodes (N3b)Distant Metastases (Stage IV):Prolong survival and improve quantity of lifeQHormonal therapies are preferred to cytotoxic therapy as it is associated with minimal toxicityQIndications of Hormonal Therapy* Hormone receptor positive (ER/PR positive)Q* Bone or soft tissue metastases onlyQ* Limited or asymptomatic visceral metastasesIndications of systemic chemotherapy* Hormone receptor negativeQ* Hormone refractoryQ (after 3 endocrine regimens)* Symptomatic visceral metastasesQAdjuvant (or neoadjuvant) chemotherapy is the standard of care for adults with a diagnosis of rhabdomyosarcoma or Ewing's sarcoma (PNET). In addition, adults with a typical osteosarcoma of bone should receive neoadjuvant or adjuvant chemotherapy in addition to therapy for local control of the tumor. - Devita 9/ePeripheral primitive neuroectodermal tumor of the chest wall is a rare malignant tumor usually occurring in children. The tumor shares a similar histology, immunohistology and cytogenetics to Ewing's sarcoma. Neoadjuvant chemotherapy is given initially and is followed by complete surgical resectioning of the mass followed by repeat chemotherapy with or without radio- therapy. - style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">'Neoadjuvant chemotherapy is indicated for the patients (of carcinoma ovary) with suboptimal stage 3 and stage 4 diseases in lieu of debulking surgery. Two or three cycles of chemotherapy before cytoreductive surgery may be helpful in patients with massive ascites and large pleural effusions. The chemotherapy may dry up the effusions, improve patients performance status and decrease postoperative morbidity, particularly chest morbidity.'- Novaks 14/e p1493
Osteosarcoma
Chest wall PNET
Breast cancer stage 2
Ovarian cancer stage 3
Miscellaneous (Neoplasia)