Paclitaxel and epirubicin followed by cyclophosphamide, methotrexate and 5-fluorouracil for patients with stage IIIC breast cancer with ten or more involved axillary lymph nodes
| Autor: | Cristian Massacesi, Angelo Dinota, Francesca Giorgi, Luigi Manzione, Diego Tummarello, Chiara Braconi, Nicola Battelli, Stefano Cascinu, Donatella Morale, Fabio Sturba, Alberto Scanni, Giusi Giacomini, Stefano Cobelli, Alberta Pilone |
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| Rok vydání: | 2006 |
| Předmět: |
Oncology
Adult Cancer Research medicine.medical_specialty Axillary lymph nodes Cyclophosphamide Paclitaxel Breast Neoplasms Gastroenterology Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Mastectomy Aged Epirubicin business.industry CMF Regimen Middle Aged medicine.disease Survival Analysis Regimen medicine.anatomical_structure Methotrexate Fluorouracil Chemotherapy Adjuvant Lymphatic Metastasis Female business Tamoxifen medicine.drug |
| Zdroj: | American journal of clinical oncology. 29(4) |
| ISSN: | 1537-453X |
| Popis: | Objective: The aim of this study was to evaluate the feasibility of a combination of epirubicin and paclitaxel followed by intravenous (iv) cyclophosphamide, methotrexate, and 5-fluorouracile (CMF) as adjuvant treatment of breast cancer patients with 10 or more metastatic axillary lymph nodes. Methods: Forty-four patients entered this multicenter study and received 4 cycles of epirubicin (E 120 mg/m2 day 1, q3 weeks) and paclitaxel (T 135 mg/m2 day 1, q3 weeks), followed by 4 cycles of iv CMF (days 1 and 8, q4 weeks). Patients with positive hormonal receptors received sequentially tamoxifen associated with LH-RH analogue if premenopausal. The endpoints were the evaluation of the feasibility of this schedule and disease free survival (DFS). Results: Median age of patients was 55; median number of positive axillary nodes was 14 (range, 10–47). Hormonal receptor status was positive in 57% of patients. The combination of epirubicin and paclitaxel was well tolerated; NCI grade 3/4 events were: leucopenia in 27% of patients, neutropenic fever in 5 patients, anemia in 7%, thrombocytopenia in 7%, nausea in 18%, vomiting in 14%, and neurotoxicity in 4%. CMF regimen caused a few cases of grade 3/4 hematologic toxicity. No cardiac toxicity was recorded. With a median follow-up of 59 months, 18 (41%) patients relapsed. Sites of relapse were mainly bone, skin/soft tissues, liver, and lung. Median DFS was 78 months, with a 5-year rate of 60%. Conclusions: The combination of paclitaxel at low dose and epirubicin followed by CMF is a feasible regimen, which seems to be effective in high-risk node positive breast cancer patients and requires further investigations. |
| Databáze: | OpenAIRE |
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