Abstract |
The purpose of this study was to evaluate the toxicity and efficacy of high-dose busulfan, melphalan and thiotepa (Bu/Mel/TT) in patients with high-risk non- inflammatory breast cancer defined as stage II disease > or =10 lymph nodes (n = 52) or stage III (n = 69), and prognostic factors for treatment outcome. One hundred and twenty-one patients (median age, 46 years) were treated with high-dose Bu (12 mg/kg), Mel (100 mg/m2) and TT (500 mg/m2) (HDC) followed by autologous stem cell infusion (ASCI). One hundred patients were initially treated with surgery followed by standard adjuvant chemotherapy prior to HDC/ASCI. Twenty-one patients with stage III disease had inoperable tumors at diagnosis and were treated with neoadjuvant chemotherapy and surgery before HDC/ASCI. Transplant-related mortality was 6%. The probabilities of event-free survival (EFS) at 3 and 5 years (median follow-up of 36 months) from transplant were, for all patients: 0.62-0.60; stage II: 0.71-0.67: stage III: 0.55-0.55 (for stage III adjuvant and neoadjuvant groups: 0.60-0.60 and 0.42-0.42, respectively). Multivariate analysis did not identify variables associated with poor outcome. The efficacy of Bu/Mel/TT is similar to other HDC regimens reported for patients with high-risk non- inflammatory breast cancer. Bu/Mel/TT has high activity in stage II disease and a moderate benefit in stage III operable tumors.
|
Authors | F Gutierrez-Delgado, L A Holmberg, H Hooper, F R Appelbaum, R B Livingston, R T Maziarz, P Weiden, S Rivkin, P Montgomery, K Kawahara, W Bensinger |
Journal | Bone marrow transplantation
(Bone Marrow Transplant)
Vol. 26
Issue 1
Pg. 51-9
(Jul 2000)
ISSN: 0268-3369 [Print] England |
PMID | 10918405
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
|
Chemical References |
- Thiotepa
- Busulfan
- Melphalan
|
Topics |
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects, therapeutic use)
- Breast Neoplasms
(drug therapy, mortality, surgery, therapy)
- Busulfan
(administration & dosage)
- Chemotherapy, Adjuvant
- Disease-Free Survival
- Female
- Follow-Up Studies
- Hematopoietic Stem Cell Transplantation
- Humans
- Inflammation
- Melphalan
(administration & dosage)
- Middle Aged
- Multivariate Analysis
- Neoplasm Staging
- Survival Rate
- Thiotepa
(administration & dosage)
- Time Factors
|