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Organo Oficial de la Asociación Mexicana de Mastología

2014, Number 3

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Rev Mex Mastol 2014; 4 (3)

Effectiveness analysis of neoadjuvant epirubicin of high dose using 4 vs. 6 cycles in patients with locally advanced breast cancer

Ramírez-Torres N, Pérez-Puentes A, Astudillo-de la Vega H

Language: Spanish
References: 43
Page: 91-99
PDF size: 329.54 Kb.


ABSTRACT

Purpose: Cytostatic agents such as antracyclines have showed to be effective in locally advanced breast cancer (LABC). Epirubicin can be used in high dose without increasing severe toxicity. Our aim was to assess high dose epirubicin using 4 vs. 6 cycles. Patients and methods: Patients diagnosed with LABC in our hospital were included. One cohort (n = 48) of patients received 5-fluorouracil 500 mg/m2, epirubicin 100 mg/m2 and cyclophosphamide 600 mg/m2 (FE100C) every 21 days by 4 cycles (4FE100C). Other cohort (n = 48) received 6 cycles (6FE100C) of the same scheme. All patients were followed by surgery, radiotherapy and chemotherapy adjuvant. Results: Objective response rate (ORR) was 62.5% for 4FE100C cohort and 85.7% for 6FE100C cohort (p ‹ 0.004). There was a no significative increase in the rates of pCR (20.8%; p = 0.273) and negative lymph nodes after chemotherapy (37.5%; p = 0.960) when number of cycles received was increased. The principal toxicity by 6FE100C was vomiting (52.4%, p = 0.001) and nausea (91.6%; p = .563), both toxicities were grade 1-2. Odds ratio indicated that the use of 6FE100C compared with 4FE100C increased 1.6 folds the pCR in patients with LABC and intensive dose is the most important controllable factor to determine the pCR without increasing severe toxicity. Conclusion: The benefit of clinical and pathological response was better with a longer treatment of 6 cycles using high dose epirubicin.


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