title: Doubling of the epirubicin dosage within the 5-fluorouracil, epirubicin and cyclophosphamide regimen: a prospective, randomized, multicentric study on antitumor effect and quality of life in advanced breast cancer.
abstract: In metastatic breast cancer (MBC) doubling the epirubicin (EPI) dose intensity (DI) within the FEC (5-fluorouracil, EPI, cyclophosphamide) regimen could increase the response rate (RR) and ameliorate the quality of life (QoL) over standard FEC. From May, 1995, 74 consecutive patients with MBC were randomly treated with 6 courses of two FEC regimens containing 60 (60FEC) or 120 (120FEC, supported by primary G-CSF) mg/m2 of EPI. Drugs were administered every 21 days. The QoL was assessed over and after treatment by the EORTC QLQ-C30 (VER 2.0) and QLQ-BR23 questionnaires, compiled by the patient, and the Spitzer's QL-index, compiled by the physician. The study was prematurely closed in May, 1997, due to RR and QoL data of 4th interim analysis. The delivered EPI DI was 20.0 and 37.9 mg/m2/week in 60- and in 120FEC, respectively. Among the two regimens, there was no statistically significant difference in RR or in improvement of baseline overall QoL. With respect to 60FEC patients, the 120FEC patients had longer time to progression (19.2 vs 13.1 mos, p=0.04). Over baseline, the 120- but not the 60FEC patients had significantly greater pain decrease and lower deterioration of body image. In MBC, both 60- and 120FEC regimens furnished the same RR and improvement in overall baseline QoL. With respect to 60FEC patients, the 120FEC patients experienced longer time to progression. Over baseline, pain decrease and preservation of body image were also greater in these patients.
authors.affiliation: Cattedra di Oncologia Medica, Medicina Interna ed Oncologia Medica, IRCCS Policlinico San Matteo, I-27100 Pavia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Riccardi
authors.forename: C
authors.initials: C
authors.lastname: Tinelli
authors.forename: S
authors.initials: S
authors.lastname: Brugnatelli
authors.forename: P
authors.initials: P
authors.lastname: Pugliese
authors.forename: V
authors.initials: V
authors.lastname: Giardina
authors.forename: M
authors.initials: M
authors.lastname: Giordano
authors.forename: M
authors.initials: M
authors.lastname: Danova
authors.forename: A
authors.initials: A
authors.lastname: Richetti
authors.forename: S
authors.initials: S
authors.lastname: Fava
authors.forename: E
authors.initials: E
authors.lastname: Rinaldi
authors.forename: V
authors.initials: V
authors.lastname: Fregoni
authors.forename: G
authors.initials: G
authors.lastname: Trotti
authors.forename: A
authors.initials: A
authors.lastname: Poli
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life
chemical_list: D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil