The effect of postoperative radiotherapy on the feasibility of optimal dose adjuvant CMF chemotheraphy in stage II breast carcinoma

Journal Article · Sat Jan 01 04:00:00 EST 1983 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(83)90202-X· OSTI ID:5022821

Sulkes, A; Brufman, G; Rizel, S; Weshler, Z; Biran, S; Fuks, Z

The impact of a number of variables upon the effectiveness of adjuvant chemotherapy given to 87 patients with Stage II breast carcinoma was retrospectively analyzed. Adjuvant chemotherapy consisted of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). Drugs were given in optimal doses (85% or more of the planned dose) to 17% of the patients; in intermediate doses (66 to 84% of the planned dose) to 50% of the patients; and in low doses (65% or less of the planned dose) to 33% of the patients. Myelosuppression was the main reason for giving intermediate or low doses. At a median follow-up of three years, 84% of all patients remain alive. Radiation therapy preceding chemotherapy was given to 70% of the patients, concomitant irradation and chemotherapy to 15%, and 13 patients (15%) received chemotheapy only. Of the 14 patients who received optimal doses of CMF, 12 (86%) also received radiation therapy. Disease-free survival at three years is similar for irradiated and nonirradiated patients, but the latter have a higher incidence of local recurrence (5% vs. 15%), although the difference is not statistically significant. Delay in the intiation of chemotherapy, mostly because of the administration of postoperative irradiation, adversely affected the probability and duration of disease-free survival, particulararly in premenopausal women in whom chemotherapy was started within more than 90 days of mastectomy. The administration of optimal doses of adjuvant chemotherapy should follow the primary treatment to the breast tumor as closely as possible. If radiation therapy is indicated as well, it should be delivered concomitantly with chemotherapy, given the feasibility of administering both modalities simultaneously, as demonstrated in this study.

• Research Organization: Hadassah Univ. Hospital, Jerusalem, Israel
• OSTI ID: 5022821
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 9:1; ISSN IOBPD
• Country of Publication: United States
• Language: English

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550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
ALKYLATING AGENTS
ANTIMETABOLITES
AZINES
BODY
CARCINOMAS
CHEMOTHERAPY
DISEASES
DRUGS
ENDOXAN
EVALUATION
FLUOROURACILS
GLANDS
HETEROCYCLIC COMPOUNDS
HYDROXY COMPOUNDS
IMMUNOSUPPRESSION
IMMUNOSUPPRESSIVE DRUGS
MAMMARY GLANDS
MEDICINE
METHOTREXATE
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC FLUORINE COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PATIENTS
PYRIMIDINES
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SURGERY
SURVIVAL TIME
THERAPY
URACILS