[Combination of high-dose chemotherapy with autologous hematopoietic stem cell transplantation for recurrent and high-risk breast cancer: a pilot study].
OBJECTIVE
To evaluate the therapeutic effectiveness and safety of combined high-dose chemotherapy (HDC) with autologous hematopoietic stem cell transplantation (AHSCT) for recurrent and high-risk breast cancer.


METHODS
Thirteen patients with recurrent or high-risk breast cancer underwent HDC with AHSCT. Seven cases had relapsed metastasis who had failed in the previous chemotherapy. Two cases had stage IV disease who had received palliative excision. Four cases had stage II or III breast cancer with over 10 positive axillary lymph nodes who had received radical surgical resection. Four cases received autologous bone marrow transplantation, and six received autologous peripheral blood stem cell transplantation. The consolidation regimen was Thiotepa 500 (250-604) mg/m2, Cyclophosphamide 4.9 (3.3-6.0) g/m2. Eight cases were also given Carboplatin 800 (400-800) mg/m2, and two received Etoposide 830 (800-830) mg/m2 instead of Thiotepa in the consolidation regimen. Twelve cases underwent endocrinotherapy after HDC with AHSCT, six operated cases underwent radiotherapy in the area of chest wall and regional lymph nodes after HDC with AHSCT.


RESULTS
After a median follow-up of 8(1-47) months, four cases achieved complete remission (CR) and 3 achieved partial remission (PR) in the 7 cases with relapsed metastasis after induction of chemotherapy, PR patients achieved CR after HDC with AHSCT. The disease free survival (DFS) was 1-31 months in these 7 cases. One of two stage IV cases achieved CR and the other had progressive disease (PD) after induction chemotherapy, but the PD patient achieved PR after HDC with AHSCT, they underwent local radiotherapy after HDC with AHSCT and DFS was 5 and 22 months, respectively. The DFS was from 1-47 months in 4 cases with stage II or III disease.


CONCLUSIONS
HDC with AHSCT is a highly potential therapeutic means for recurrent and high-risk breast cancer paitents.
Shi
Y
Y
Department of Medical Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021.
Pan
F
F
Han
X
X
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D016190:Carboplatin / Q000008:administration & dosage; D018270:Carcinoma, Ductal, Breast / Q000556:secondary / Q000628:therapy*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D013852:Thiotepa / Q000008:administration & dosage; D014182:Transplantation, Autologous
D003520:Cyclophosphamide; D013852:Thiotepa; D016190:Carboplatin