Adjuvant chemo- and hormonal therapy in locally advanced breast cancer: a randomized clinical study
Between 1977 and 1980, 118 breast cancer patients with locally advanced disease, T3B-4, any N, M0 or T1-3, tumor positive axillary apex biopsy, were randomized to one of three arms: I: radiotherapy (RT) to the breast and adjacent lymph node areas; II: RT followed by 12 cycles of cyclophosphamide, methotrexate, 5 fluorouracil (CMF) and tamoxifen during the chemotherapy period; III: 2 cycles of adriamycin and vincristine (AV), alternated with 2 cycles of CMF, then RT, followed by another 4 cycles of AV, alternated with 4 CMF; tamoxifen during the entire treatment period. The median follow-up period was 5 1/2 years. The adjuvant chemo- and hormonal therapy did not improve the overall survival; the 5-year survival was 37% for all three treatment arms. There was no statistically significant difference in RFS between the three modalities, nor when arm I was compared to arm II and III together. LR was not statistically different over the three treatment arms. In 18 of the 24 patients with LR, distant metastases appeared within a few months from the local recurrence. The menopausal status did not influence the treatment results. Dose reduction in more than 4 cycles of chemotherapy was accompanied by better results. In conclusion: adjuvant chemo- and hormonal therapy did not improve RFS and overall survival. These findings do not support the routine use of adjuvant chemo- and endocrine therapy for inoperable breast cancer.
- Research Organization:
- Netherlands Cancer Institute, Amsterdam
- OSTI ID:
- 6041661
- Journal Information:
- Int. J. Radiat. Oncol., Biol. Phys.; (United States), Vol. 10
- Country of Publication:
- United States
- Language:
- English
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CHEMOTHERAPY
EVALUATION
RADIOTHERAPY
DOXORUBICIN
ENDOXAN
FLUOROURACILS
LYMPH NODES
MAMMARY GLANDS
MENOPAUSE
METHOTREXATE
ONCOVIN
PATIENTS
ALKALOIDS
ALKYLATING AGENTS
ANTI-INFECTIVE AGENTS
ANTIBIOTICS
ANTIMETABOLITES
ANTIMITOTIC DRUGS
ANTINEOPLASTIC DRUGS
AZINES
BODY
DRUGS
GLANDS
HETEROCYCLIC COMPOUNDS
HYDROXY COMPOUNDS
IMMUNOSUPPRESSIVE DRUGS
LYMPHATIC SYSTEM
MEDICINE
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC FLUORINE COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PYRIMIDINES
RADIOLOGY
THERAPY
URACILS
550603* - Medicine- External Radiation in Therapy- (1980-)