High dose, dose-intensive chemotherapy with doxorubicin and cyclophosphamide for the treatment of advanced breast cancer.

2.50
Hdl Handle:
http://hdl.handle.net/10541/99744
Title:
High dose, dose-intensive chemotherapy with doxorubicin and cyclophosphamide for the treatment of advanced breast cancer.
Authors:
Ferguson, J E; Dodwell, David J; Seymour, A M; Richards, M A; Howell, Anthony ( 0000-0002-3879-5991 )
Abstract:
Eighteen patients with advanced breast cancer were commenced on treatment with high dose doxorubicin (100 mg m-2) or doxorubicin (100 mg m-2) and cyclophosphamide (500 mg m-2) at 2 weekly intervals. Three cycles of treatment were planned. rG-CSF was given subcutaneously for 10 days, starting 24 h after each cycle of chemotherapy. Sixteen out of 18 patients responded (89%) of whom six (33%) achieved a complete remission. Twelve (67%) completed the three planned cycles, four (22%) received two cycles and two (11%) received one cycle only. The median time to progression was 5 1/2 months and the median survival was 18 1/2 months. Neutropenia occurred after 89% of courses and 65% of courses were accompanied by a significant (WHO grade III or IV) infection. The duration of neutropenia was short (mean 5.4 days) and mean time to absolute neutrophil count recovery (ANC > 1,000 x 10(6) litre) from the start of treatment was 11 days. Moderate to severe epithelial toxicity (WHO grade 3 or 4) accompanied 43% of courses and was dose limiting. Conclusion: High dose, dose intensive chemotherapy has an excellent initial therapeutic effect in advanced breast cancer but does not prolong duration of remission or overall survival beyond that of standard treatment. Although subcutaneous rG-CSF curtailed the expected duration of neutropenia substantially, the overall incidence of neutropenia and of infections requiring intravenous antibiotics was high. Furthermore, almost half of the courses were complicated by moderate to severe oral mucositis and/or mild to moderate palmar and plantar inflammation. The lack of survival benefit and excess toxicity seriously limits the wider application of this regime. It should not be used in place of standard dose palliative chemotherapy for metastatic breast cancer.
Affiliation:
CRC Department of Medical Oncology, Christie Hospital, Manchester, UK.
Citation:
High dose, dose-intensive chemotherapy with doxorubicin and cyclophosphamide for the treatment of advanced breast cancer. 1993, 67 (4):825-9 Br. J. Cancer
Journal:
British Journal of Cancer
Issue Date:
Apr-1993
URI:
http://hdl.handle.net/10541/99744
PubMed ID:
7682432
Type:
Article
Language:
en
ISSN:
0007-0920
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorFerguson, J Een
dc.contributor.authorDodwell, David Jen
dc.contributor.authorSeymour, A Men
dc.contributor.authorRichards, M Aen
dc.contributor.authorHowell, Anthonyen
dc.date.accessioned2010-05-24T15:41:17Z-
dc.date.available2010-05-24T15:41:17Z-
dc.date.issued1993-04-
dc.identifier.citationHigh dose, dose-intensive chemotherapy with doxorubicin and cyclophosphamide for the treatment of advanced breast cancer. 1993, 67 (4):825-9 Br. J. Canceren
dc.identifier.issn0007-0920-
dc.identifier.pmid7682432-
dc.identifier.urihttp://hdl.handle.net/10541/99744-
dc.description.abstractEighteen patients with advanced breast cancer were commenced on treatment with high dose doxorubicin (100 mg m-2) or doxorubicin (100 mg m-2) and cyclophosphamide (500 mg m-2) at 2 weekly intervals. Three cycles of treatment were planned. rG-CSF was given subcutaneously for 10 days, starting 24 h after each cycle of chemotherapy. Sixteen out of 18 patients responded (89%) of whom six (33%) achieved a complete remission. Twelve (67%) completed the three planned cycles, four (22%) received two cycles and two (11%) received one cycle only. The median time to progression was 5 1/2 months and the median survival was 18 1/2 months. Neutropenia occurred after 89% of courses and 65% of courses were accompanied by a significant (WHO grade III or IV) infection. The duration of neutropenia was short (mean 5.4 days) and mean time to absolute neutrophil count recovery (ANC > 1,000 x 10(6) litre) from the start of treatment was 11 days. Moderate to severe epithelial toxicity (WHO grade 3 or 4) accompanied 43% of courses and was dose limiting. Conclusion: High dose, dose intensive chemotherapy has an excellent initial therapeutic effect in advanced breast cancer but does not prolong duration of remission or overall survival beyond that of standard treatment. Although subcutaneous rG-CSF curtailed the expected duration of neutropenia substantially, the overall incidence of neutropenia and of infections requiring intravenous antibiotics was high. Furthermore, almost half of the courses were complicated by moderate to severe oral mucositis and/or mild to moderate palmar and plantar inflammation. The lack of survival benefit and excess toxicity seriously limits the wider application of this regime. It should not be used in place of standard dose palliative chemotherapy for metastatic breast cancer.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBreast Neoplasms-
dc.subject.meshCyclophosphamide-
dc.subject.meshDose-Response Relationship, Drug-
dc.subject.meshDoxorubicin-
dc.subject.meshFemale-
dc.subject.meshGranulocyte Colony-Stimulating Factor-
dc.subject.meshHumans-
dc.subject.meshInjections, Subcutaneous-
dc.subject.meshMiddle Aged-
dc.subject.meshRecombinant Proteins-
dc.titleHigh dose, dose-intensive chemotherapy with doxorubicin and cyclophosphamide for the treatment of advanced breast cancer.en
dc.typeArticleen
dc.contributor.departmentCRC Department of Medical Oncology, Christie Hospital, Manchester, UK.en
dc.identifier.journalBritish Journal of Canceren

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