Translational Health Reports

Abstract Background: Chemoradiation therapy (CRT) is fundamental for treating locally advanced and high-risk breast cancer. Although effective, it significantly impacts systemic physiology, which can be tracked through fluctuations in serum biomarkers. This review consolidates existing research on how CRT affects circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), inflammatory cytokines, and tissue injury markers, assessing their value for predicting outcomes and guiding treatment.
Methods: A systematic search of PubMed, Embase, Scopus, and Web of Science was conducted for studies to 2025. Keywords included "breast cancer," "chemoradiation," "serum biomarker," "ctDNA," "CTC," and related terms. Eligible studies reported serum biomarker levels in breast cancer patients before, during, or after CRT and linked them to clinical results.
Results: Analysis of studies indicates that CRT causes a predictable but individualized alteration in serum biomarkers. A swift decrease in CTCs and ctDNA levels during neoadjuvant or definitive CRT strongly correlates with pathological complete response (pCR) and better survival. In contrast, detectable ctDNA after treatment is a powerful indicator of minimal residual disease (MRD) and impending relapse. Inflammatory markers such as IL-6 and CRP generally increase during therapy; prolonged elevation is linked to poorer prognosis and greater toxicity. Additionally, biomarkers like high-sensitivity Troponin I and TGF-β1 enable early identification of subclinical cardiotoxicity and radiation-induced skin damage, respectively.
Conclusion: Serum biomarkers offer a real-time, dynamic reflection of tumor response and host toxicity during CRT. Incorporating liquid biopsy components (CTCs, ctDNA) and host-response markers into clinical practice shows great potential for personalizing treatment, facilitating early intervention, and enhancing long-term results. Prospective studies are urgently required to standardize testing methods and confirm their clinical utility in guiding treatment strategies.

Abstract Background: Neoadjuvant chemotherapy is a common treatment approach for breast cancer, but its impact on disease-free survival, quality of life, and recurrence rates is not well understood.

Objectives: To evaluate the association between neoadjuvant chemotherapy and disease-free survival, quality of life, and recurrence rates in patients with breast cancer.

Methods: This retrospective cohort study included 350 patients with breast cancer who underwent surgery at a university clinic between 2015 and 2022. Patients were divided into two groups: those who received neoadjuvant chemotherapy (n=105) and those who did not (n=245). Demographic, tumor, and treatment characteristics were compared between groups. Disease-free survival, quality of life, and recurrence rates were analyzed using Cox proportional hazards models, multivariate analysis of variance, and logistic regression models. 1 year follow ups were made.

Results: Patients who received neoadjuvant chemotherapy had a significant reduction in the risk of disease recurrence (HR=0.65, p=0.02) and local recurrence (OR=0.42, p=0.01). However, they had lower physical and social functioning scores compared to those who did not receive neoadjuvant chemotherapy (p=0.04 and p=0.02, respectively). Neoadjuvant chemotherapy was also associated with a higher survival rate at 12 months (92.5% vs. 85.1%, p=0.03).

Conclusions: Neoadjuvant chemotherapy is associated with improved disease-free survival and reduced local recurrence rates in patients with breast cancer. However, it may have a negative impact on quality of life, particularly physical and social functioning. These findings have implications for the management of breast cancer and highlight the need for further research on the optimal use of neoadjuvant chemotherapy.