Breast conservation and prolonged chemotherapy for locally advanced breast cancer: The University of Michigan experience
Breast conservation and prolonged chemotherapy for locally advanced breast cancer: The University of Michigan experience
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DOI：
10.1200/jco.1997.15.8.2873
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发表时间：
1997-08-01
影响因子：
45.3
通讯作者：
Pierce, LJ
中科院分区：
文献类型：
--
作者：
Merajver, SD;Weber, BL;Pierce, LJ
Purpose: To determine whether breast conservation and prolonged neoadjuvant chemotherapy have efficacy in locally advanced breast cancer (LABC), as measured by survival and rate of breast conservation.Materials and Methods: Eighty-nine patients with stage III disease were enrolled at the University of Michigan (UM) onto a prospective nonrandomized trial. Patients received nine 21-day cycles of neoadjuvant chemohormonal therapy that consisted of doxorubicin 30 mg/m(2) and cyclophosphamide 750 mg/m(2) intravenously on day 1, conjugated estrogens 0.625 mg orally twice daily on days 6 to 8, methotrexate 40 mg/m(2) and fluorouracil 500 mg/m(2) intravenously on day 8, and tamoxifen 10 mg orally twice daily on days 9 to 14. Patients with a negative biopsy received radiation only, while those with residual disease underwent mastectomy and postoperative radiotherapy. Eight more cycles of chemohormonal therapy were administered after local-regional therapy.Results: The clinical response rate to neoadjuvant therapy was 97%, 28% of patients had a complete pathologic response evaluated at biopsy. Five-year overall and disease-free survival probabilities were 54% and 44%, respectively. The median disease-free survival time was 2.4 years. The 5-year actuarial rates of local-regional control with local failure as only first failure were 82% and 78% following radiotherapy, and mastectomy and radiotherapy, respectively (P =.99).Conclusion: Prolonged neoadjuvant chemohormonal therapy and biopsy-driven local therapy have efficacy in LABC, with 28% of patients being candidates for breast conservation and a ti-year overall survival rate of 54%. (C) 1997 by American Society of Clinical Oncology.
