title: Frequent dose delays and growth factor requirements with the sequential doxorubicin-CMF schedule.
abstract: Doxorubicin for four cycles plus cyclophosphamide, methotrexate and 5-fluorouracil (CMF) for eight cycles is an effective adjuvant regimen for breast cancer patients with more than three involved axillary lymph nodes. We reviewed the incidence of dose delays and growth factor requirements when this regimen is administered to patients receiving concurrent irradiation. Thirty-six patients with more than three involved axillary lymph nodes were treated with the sequential regimen doxorubicin-CMF and irradiation. Patients with two or more dose delays received G-CSF treatment. Seventy-five percent of the patients required dose delays for day-22 neutropenia, and growth factors were needed for half of the patients in order to maintain a received dose intensity of 0.940. The first delayed cycle occurred in 74% of the patients while receiving concomitant chemoradiotherapy. Frequent dose delays were required when the sequential regimen doxorubicin-CMF was administered along with radiotherapy. Growth factors are needed to maintain dose intensity similar to that achieved in the original trial.
authors.affiliation: Medical Oncology Service, Hospital General Universitari Vall d'Hebron, Barcelona, Spain. aribas@surgery.medsch.ucla.edu
authors.forename: A
authors.initials: A
authors.lastname: Ribas
authors.forename: J
authors.initials: J
authors.lastname: Albanell
authors.forename: J
authors.initials: J
authors.lastname: Bellmunt
authors.forename: B
authors.initials: B
authors.lastname: Bermejo
authors.forename: E
authors.initials: E
authors.lastname: Gallardo
authors.forename: R
authors.initials: R
authors.lastname: Vera
authors.forename: R
authors.initials: R
authors.lastname: Bodi
authors.forename: L A
authors.initials: LA
authors.lastname: Solé-Calvo
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000627:therapeutic use; D006133:Growth Substances / Q000627:therapeutic use*; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged
chemical_list: D000903:Antibiotics, Antineoplastic; D006133:Growth Substances; D016179:Granulocyte Colony-Stimulating Factor; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate