title: Modulations of dose intensity of doxorubicin and cyclophosphamide in association with G-CSF and peripheral blood stem cells in adjuvant chemotherapy for breast cancer: comparative evaluation of completion and safety of three intensive regimens.
abstract: The aim of this study was to evaluate and to compare in terms of toxicity the modulations of dose intensity of cyclophosphamide and doxorubicin in adjuvant chemotherapy for high-risk breast cancer. Four cycles of sequential high-dose chemotherapy with doxorubicin and cyclophosphamide (AC), supported with G-CSF and peripheral blood stem cells (PBSC) were administered to 81 women. Three successive cohorts were studied: doxorubicin (75 mg/m(2)) + cyclophosphamide (3000 mg/m(2)) every 21 days (group 1), doxorubicin (75 mg/m(2)) + cyclophosphamide (3000 mg/m(2)) every 15 days (group 2), and doxorubicin (75 mg/m(2)) + cyclophosphamide (6000 mg/m(2)) every 21 days (group 3). Seventy-five patients received four cycles of treatment with a total of 310 cycles administered. The received dose intensity of doxorubicin was higher in group 2 and that of cyclophosphamide was lower in group 1 than in the other two groups. Hematological and extra-hematological toxicities, as well as the number and duration of hospitalizations for toxicity, were significantly higher in group 3. We conclude that the group 3 regimen is associated with toxicities comparable to autologous transplantation. Increasing dose intensity of doxorubicin and cyclophosphamide is feasible in an outpatient setting and safe in groups 1 and 2 with the support of hematopoietic factor and PBSC.
authors.affiliation: Medical Oncology Department, Université de la Méditerranée, Marseilles, France.
authors.forename: D
authors.initials: D
authors.lastname: Genre
authors.forename: P
authors.initials: P
authors.lastname: Viens
authors.forename: F
authors.initials: F
authors.lastname: Bertucci
authors.forename: C
authors.initials: C
authors.lastname: Chabannon
authors.forename: G
authors.initials: G
authors.lastname: Gravis
authors.forename: A-C
authors.initials: AC
authors.lastname: Braud
authors.forename: J
authors.initials: J
authors.lastname: Camerlo
authors.forename: G
authors.initials: G
authors.lastname: Houvenaeghel
authors.forename: V
authors.initials: V
authors.lastname: Moutardier
authors.forename: A
authors.initials: A
authors.lastname: Goncalvez
authors.forename: C
authors.initials: C
authors.lastname: Protière
authors.forename: V-J
authors.initials: VJ
authors.lastname: Bardou
authors.forename: D
authors.initials: D
authors.lastname: Maraninchi
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000592:standards / Q000633:toxicity; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D019172:Transplantation Conditioning / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D004317:Doxorubicin; D003520:Cyclophosphamide