title: A phase III study of high-dose intensification without hematopoietic progenitor cells support for patients with high-risk primary breast carcinoma.
abstract: Patients with more than nine ipsilateral lymph node involvement or inflammatory breast cancer have a 5-year survival rate of approximately 50%. We studied the efficacy of high-dose intensification, comparing it with the standard dose chemotherapy for patients with high-risk primary breast cancer. Patients with inflammatory breast cancer or more than nine ipsilateral lymph node involvement without evidence of distant metastasis were randomized to receive either standard dose 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC) every 3 weeks for nine courses (control) or six courses of FAC followed by two courses of cyclophosphamide (5.25 g/m2), etoposide (1,500 mg/m2), and cisplatin (165 mg/m2) (HDCVP). The study was terminated in 1998 because of slow accrual of patients. Forty-six patients were entered in the study. At 4 years, the overall survival was 72.8% (SE 11.9%) and 61.7% (SE 12.4%), and disease-free survival were 45.5% (SE 12.3%) and 33.7% (SE 11.9%) for the control and HDCVP groups, respectively (p = 0.757 and 0.720). With the small number of patients in our study, a small overall survival benefit of high-dose intensification compared with the standard therapy cannot be excluded. However, any substantial benefit is unlikely.
authors.affiliation: Ottawa Regional Cancer Centre, Ontario, Canada.
authors.forename: J C
authors.initials: JC
authors.lastname: Yau
authors.forename: S Z
authors.initials: SZ
authors.lastname: Gertler
authors.forename: J
authors.initials: J
authors.lastname: Hanson
authors.forename: S
authors.initials: S
authors.lastname: Verma
authors.forename: L J
authors.initials: LJ
authors.lastname: Grimard
authors.forename: S T
authors.initials: ST
authors.lastname: Malik
authors.forename: I M
authors.initials: IM
authors.lastname: Aref
authors.forename: P W
authors.initials: PW
authors.lastname: Cross
authors.forename: E M
authors.initials: EM
authors.lastname: Tomiak
authors.forename: D J
authors.initials: DJ
authors.lastname: Stewart
authors.forename: D A
authors.initials: DA
authors.lastname: St Cyr
authors.forename: S D
authors.initials: SD
authors.lastname: Huan
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality; D018567:Breast Neoplasms, Male / Q000188:drug therapy*; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D005472:Fluorouracil