medigraphic.com
ISSN 1870-2821 (Print)
Organo Oficial de la Asociación Mexicana de Mastología

2014, Number 3

<< Back Next >>

Rev Mex Mastol 2014; 4 (3)

Analysis of the effectiveness of neoadjuvant epirubicin with conventional dose in patients with locally advanced breast cancer

Ruiz-García E, Ramírez-Torres N, López-Camarillo C, Marchat LA, Silva JA, Guadarrama-Orozco JA, Astudillo-de la Vega H

Language: Spanish
References: 23
Page: 81-86
PDF size: 276.25 Kb.


ABSTRACT

Objective: A retrospective cohort study of patients with locally advanced breast cancer (LABC). The purpose was to evaluate the pathological complete response to neoadjuvant chemotherapy with conventional dose schedule with 5-fluorouracil, epirubicin and cyclophosphamide (FEC respectively). Patients and methods: Patients diagnosed with stage III breast cancer were selected from January 1999 to December 2000. 63 patients received FEC (500 mg/m2, 75 mg/m2, and 500 mg/m2, respectively) every 3 weeks for 4 cycles followed by surgery and radiotherapy. The patients also received adjuvant chemotherapy. Variables such as age, histological type, histological grade, initial tumor size, and clinical axillary node size before and after chemotherapy, adjuvant chemotherapy were evaluated. Results: A clinical objective response rate (ORR) of 77.7% (RC 58.7%; RP 19%) a pathological complete response rate (RPc) of 14.2% (n = 9) and negative axillary lymph rate of 33.3% (n = 21) were obtained. The predominant data were old patient (60.3%), tumor size category T3 (44.4%), lymph node conglomerate type N2 (61.9%), stage IIIA (57.1%), moderately differentiated tumor (66.6%), ductal adenocarcinoma (75%) and absence of vascular permeation (81%). Conclusion: This study showed that neoadjuvant FEC scheme of four cycles with conventional dose for treating patients with LABC presented a low rate of RPc.


REFERENCES

  1. Carter CL, Allen C, Henson DE. Relation of tumor size, lymph node status and survival in 24,740 breast cancer cases. Cancer. 1989; 63: 181-187.

  2. Tercera revisión del Consenso Nacional sobre Diagnóstico y Tratamiento del Cáncer Mamario. GAMO. 2008; 7 Supl. 6: 2.

  3. Shenkier T, Weir L, Levine M et al. Clinical practice guidelines for the care and treatment of breast cancer: 15. Treatment for women with stage III or locally advanced breast cancer. CMAJ. 2004; 170: 983-994.

  4. Esteva FJ, Hortobagyi GN. Integration of systemic chemotherapy in the management of primary breast cancer. Oncologist. 1988; 3: 300-313.

  5. Jacquillat C, Weil M, Baillet F et al. Results of the neoadjuvant chemotherapy, and external and radiation therapy in breast-conserving treatment of 250 patients with all stages of infiltrative breast cancer. Cancer. 1990; 66: 119-129.

  6. Cocconi G, di Blasio B, Bisagni G et al. Neoadjuvant chemotherapy and endocrine therapy in locally advanced breast carcinoma. A prospective randomized study. Am J Oncol. 1990; 13: 226-232.

  7. Hortobagyi GN, Ames FC, Buzdar AU. Management of stage III primary breast cancer with primary chemotherapy, surgery and radiation therapy. Cancer. 1988; 62: 2507-2516.

  8. Fisher B, Brown AM, Mamounas E et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast Project B-18. J Clin Oncol. 1997; 15: 2483-2493.

  9. Bonadonna G, Valagussa P, Brambilla C, Ferrari L, Moliterni A, Terenziani M et al. Primary chemotherapy in operable breast cancer: eight-year experience at the Milan Cancer Institute. J Clin Oncol. 1998; 16: 93-100.

  10. Buzdar AU, Singletary SE, Theriault RL, Booser DJ, Valero V, Ibrahim N et al. Prospective evaluation of paclitaxel versus combination chemotherapy with fluorouracil, doxorubicin, and cyclophosphamide as neoadjuvant therapy in patients with operable breast cancer. J Clin Oncol. 1999; 17: 3412-3417.

  11. Feldman DL, Hortobagyi GN, Buzdar AU et al. Pathologic assessment of response to induction chemotherapy in breast cancer. Cancer Res. 1986; 46: 2578-2581.

  12. Calais G, Berger C, Descamps P et al. Conservative treatment feasibility with induction chemotherapy, surgery and radiotherapy for patients with breast carcinoma larger than 3 cm. Cancer. 1994; 74: 1283-1288.

  13. Fisher B, Bryant J, Wolmark N et al. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 1998; 16: 2672-2685.

  14. Valero VV, Buzdar AU, Hortobagy GN. Locally advanced breast cancer. The Oncologist. 1996; 1: 8-17.

  15. Kuerer HM, Newman LA, Smith TL, Ames FC, Hunt KK, Dhingra K et al. Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy. J Clin Oncol. 1999; 17: 460-469.

  16. Singletary SE, Allred C, Ashley P et al. Revision of the American Joint Committee on Cancer staging system for breast cancer. J Clin Oncol. 2002; 20 (17): 3628-3636.

  17. Miller AB, Hoogstraten B, Staquet et al. Reporting results of cancer treatment. Cancer. 1981; 47: 207-214.

  18. Chevallier B, Roche H, Oliver JP et al. inflammatory breast cancer. Pilot study of intensive induction chemotherapy (FEC-HD) results in a high histologic response rate. Am J Clin Oncol. 1993; 16: 223-228.

  19. Dieras V, Fumoleau P, Romieu G et al. Randomized parallel study of doxorrubicin plus paclitaxel and doxorubicin plus cyclophosphamide as neoadjuvant therapy of patients with breast cancer. J Clin Oncol. 2004; 22: 4958-4965.

  20. Chollet P, Amat S, Cure H et al. Prognostic significance of a complete pathological response after induction chemotherapy in operable breast cancer. Br J Cancer. 2002; 86: 1041-1046.

  21. Lee MC, Jagsi R. Postmastectomy radiotherapy: indications and controversies. Surg Clin N Am. 2007; 87: 511-526.

  22. Early Breast Cancer Trialists’ Collaborative Group. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival. On overview of the randomized trials. Lancet. 2005; 366: 2087-2106.

  23. Recht A et al. Postmastectomy radiation therapy: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol. 2003; 83: 995-1013.




2020     |     www.medigraphic.com