title: [Successful treatment of brain metastases in breast cancer with blood-brain barrier-impervious cytostatics and hormones].
abstract: 11 patients (age 36-60 years) with breast cancer and CT-scan documented brain metastases (BM) were treated with hormonochemotherapy: 5-fluorouracil 500 mg/m2 i.v. day 1 + 8, adriamycin 50 mg/m2 i.v. day 1, cyclophosphamide 500 mg/m2 i.v. day 1-q4 weeks (FAC) and tamoxifen (TXF) 20 mg/day per os. Ovarectomy was carried out in 3 praemenopausal patients. In 3 cases single BM were surgically resected (2 subtotal, 1 total). One patient was shunted due to a hydrocephalus occlusus. Complete response (CR), i.e. normalization of CT-scan and disappearance of CNS related symptoms, was achieved in 9 out of 11 patients. One patient with partial remission (PR) and another with progressive disease died 6 and 5 months after diagnosis of BM. The median duration of remissions of all patients was 12 (5-43) months. The median survival time from diagnosis of BM was 15 (5-44) months and from mastectomy 46 (26-142) months. The cumulative probability of surviving was 63% one year after diagnosis of BM. One relapsing patient achieved a second CR, another a PR by whole brain irradiation. 4 patients survived more than 18 months from the diagnosis of BM. It appears that chemo-hormonotherapy provides a rational approach to palliation in breast cancer patients with BM in prolonging the survival.
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols; D001812:Blood-Brain Barrier / Q000187:drug effects*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000556:secondary*; D001943:Breast Neoplasms / Q000188:drug therapy*; D002369:Castration; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004317:Doxorubicin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D008525:Medroxyprogesterone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D017258:Medroxyprogesterone Acetate; D008875:Middle Aged; D011379:Prognosis; D013629:Tamoxifen / Q000008:administration & dosage*
chemical_list: D000970:Antineoplastic Agents; D013629:Tamoxifen; D004317:Doxorubicin; D003520:Cyclophosphamide; D017258:Medroxyprogesterone Acetate; D008525:Medroxyprogesterone; D005472:Fluorouracil
vernacular_title: Erfolgreiche Behandlung von Hirnmetastasen bei Mamma-Karzinom mit nicht liquorgängigen Zytostatika und Hormonen.