title: [Preoperative high-dose chemotherapy with peripheral blood stem cell support in breast cancer: report of 3 cases].
abstract: OBJECTIVE
  To investigate the possibility and short-term effect of high dose chemotherapy with peripheral blood stem cell support in the preoperative therapy of breast cancer, and-its influence on the following operation and would healing.
  
  
  METHODS
  Three patients with T(3)N(1)M(0) (III(a)), T(4)N(1)M(0) (III(b)), T(4)N(1)M(1) (IV) of breast cancer were diagnosed histopathologically. After receiving HDC/APBSCT, the 3 patients were operated on. HDC/APBSCT process included 2 cycles of FEC induction chemotherapy; PBSC mobilization, APBSC collection and cryopreservation and PBSC infusion; and high-dose chemotherapy, APBSC infusion and supportive therapy. The therapy consisted of CTX2.5 g/m(2), VP-16 600 mg/m(2), and cerboplatin 600 mg/m(2) delivered on day 1, APBSC infusion 48 h later, rhG-CSF (150 microg, BID) was administered 4 h after infusion of APBSC until WBC was higher than 10 x 10(9)/L. During HDC/APBSCT, the patients were protected in the air laminar flow room with supportive therapy of antibiotics, anti-virus and anti-fungus drugs. They left the air laminar flow room after their WBC was greater than 2 x 10(9)/L. Case 1 was treated by radical mastectomy, Case 2 by improved radical mastectomy, Case 3 by improved radical mastectomy and transplantation of skin for the large area.
  
  
  RESULTS
  Rapid recovery of bone marrow function was observed in all 3 patients. Operation was performed 4 weeks after HDC/PBSCT in Cases 1, 2 and 33 days in Case 3. No influence was seen on operative procedure and would healing, especially in Case 3 with a large area of skin transplantation. Two patients with stage III(a) and III(b) have been alive since the treatment for 30 months and the other with stage IV died of brain metastasis 16 months later.
  
  
  CONCLUSIONS
  HDC/APBSCT as a preoperative therapy for breast cancer has no influence on the coming surgery and would healing, even on skin transplantation for a large area. It has a practical response in stage III(a) and III(b), but it is still controversial in stage IV. This method as a salvage therapy for patients with breast cancer of intemuediate or stage.
authors.affiliation: Department of General Surgery, Jiangsu Provincial Tumor Hospital, Nanjing 210009, China.
authors.forename: Jinhai
authors.initials: J
authors.lastname: Tang
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Wang
authors.forename: Jianwei
authors.initials: J
authors.lastname: Qin
authors.forename: Liangxi
authors.initials: L
authors.lastname: Pan
authors.forename: Jianqiu
authors.initials: J
authors.lastname: Wu
authors.forename: Jifeng
authors.initials: J
authors.lastname: Feng
authors.forename: Xiangsheng
authors.initials: X
authors.lastname: Zhao
authors.forename: Xiuli
authors.initials: X
authors.lastname: Zheng
authors.forename: Jirong
authors.initials: J
authors.lastname: Zhu
authors.forename: Aidi
authors.initials: A
authors.lastname: Dai
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015409:Mastectomy, Radical; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D016879:Salvage Therapy