Eighteen patients with breast cancer involving more than 10 regional lymph nodes were treated by high-dose chemotherapy (HDCT) supported by peripheral blood stem cell plantation (PBSCT) as adjuvant therapy. After radical mastectomy, the combination chemotherapy with adriamycin 50 mg/m2, cyclophosphamide 1,000 mg/m2, vincristine 1.0 mg/m2 and methotrexate 200 mg/m2 with leucovorin rescue was started, and repeated every 3 weeks for 3 courses. G-CSF was also given. After the 2nd and 3rd courses, PBSCs were collected and cryopreserved. Tamoxifen was also given to patients with breast cancer containing a high concentration of estrogen receptor, and radiation therapy for supra-clavicular and parasternal lymph nodes was also combined. Finally, HD-CT with thio-TEPA 200 mg/m2/day, etoposide 300 mg/m2/day, and CPA 2,000 mg/m2/day were administered for 3 consecutive days, and after 72 hours of final doses, frozen-thawed PBSC were administered. HD-CT with PBSCT was well tolerated, and recovery from myelosuppression of the HD-CT was rather quick and no serious side effects were observed. Fifteen patients remained in remission with a median follow-up of 33 months after mastectomy, and three relapsed at 13, 19 and 21 months after surgery. According to Kaplan-Meyer analysis, the probability of disease-free survival was significantly higher in patients treated by HDCT with PBSCT as compared with those treated by conventional chemotherapy in our division, showing 75.7 % and 24.6 % respectively, at 5 years after mastectomy. HD-CT with PBSCT as adjuvant therapy for primary breast cancer with extensive lymph node involvement may improve the supposed poor prognosis of such patients.
|Number of pages||7|
|Publication status||Published - 1998|
All Science Journal Classification (ASJC) codes
- Cancer Research