TY - JOUR
T1 - Combined sequential approach in locally advanced breast cancer
AU - Zambetti, M.
AU - Oriana, S.
AU - Quattrone, P.
AU - Verderio, P.
AU - Terenziani, M.
AU - Zucali, R.
AU - Valagussa, P.
AU - Bonadonna, G.
PY - 1999
Y1 - 1999
N2 - Background: The interaction between primary and adjuvant chemotherapy is a crucial point in the treatment of locally advanced breast cancer. Objective: To evaluate the therapeutic efficacy of a sequential treatment with primary anthracyclines and adjuvant CMF in this patient subset. Design: Prospective cohort study. Patients: Eighty-eight breast cancer patients, stage T3b-T4 abc, N0-2, M0. Results: From February 1991 to July 1994, 88 consecutive patients with locally advanced breast cancer were treated at the Istituto Nazionale Tumori, Milano, with full-dose doxorubicin (75 mg/m2) or epirubicin (120 mg/m2) for three cycles followed by surgery, adjuvant chemotherapy with i.v. CMF for six cycles and local radiotherapy ± Tamoxifen. A high rate of objective responses (70%), but a low incidence of pathologic complete remission (2%), were observed following primary treatment with single-agent anthracyclines. Frequency of responses was not associated with tumor estrogen or progesterone receptors status, Mib-1 or grading. In 28 patients (32%) conservative surgery could be performed. At a median follow- up of 52 months, relapse free survival and overall survival are 52% and 62%, respectively. A multivariate analysis demonstrated a significant favorable prognosis in patients with limited nodal involvement at surgery and negative Mib-1 values. This drug sequence failed to significantly ameliorate the long term results in this unfavorable patient subset and more effective drug regimens and innovative therapeutic strategies are needed.
AB - Background: The interaction between primary and adjuvant chemotherapy is a crucial point in the treatment of locally advanced breast cancer. Objective: To evaluate the therapeutic efficacy of a sequential treatment with primary anthracyclines and adjuvant CMF in this patient subset. Design: Prospective cohort study. Patients: Eighty-eight breast cancer patients, stage T3b-T4 abc, N0-2, M0. Results: From February 1991 to July 1994, 88 consecutive patients with locally advanced breast cancer were treated at the Istituto Nazionale Tumori, Milano, with full-dose doxorubicin (75 mg/m2) or epirubicin (120 mg/m2) for three cycles followed by surgery, adjuvant chemotherapy with i.v. CMF for six cycles and local radiotherapy ± Tamoxifen. A high rate of objective responses (70%), but a low incidence of pathologic complete remission (2%), were observed following primary treatment with single-agent anthracyclines. Frequency of responses was not associated with tumor estrogen or progesterone receptors status, Mib-1 or grading. In 28 patients (32%) conservative surgery could be performed. At a median follow- up of 52 months, relapse free survival and overall survival are 52% and 62%, respectively. A multivariate analysis demonstrated a significant favorable prognosis in patients with limited nodal involvement at surgery and negative Mib-1 values. This drug sequence failed to significantly ameliorate the long term results in this unfavorable patient subset and more effective drug regimens and innovative therapeutic strategies are needed.
KW - Conservative surgery
KW - Locally advanced breast cancer
KW - Primary chemotherapy
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U2 - 10.1023/A:1008345901178
DO - 10.1023/A:1008345901178
M3 - Article
C2 - 10355574
AN - SCOPUS:0032941289
VL - 10
SP - 305
EP - 310
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 3
ER -