Abstract |
The purpose of this study was to evaluate the efficacy of concurrent chemotherapy and irradiation in inflammatory breast cancer (IBC). Between January 1990 and December 1998, forty-eight non-metastatic patients with clinical or occult IBC were treated with chemotherapy and irradiation. The induction chemotherapy consisted of epirubicin, cyclophosphamide and vindesin, in association with split-course bi-fractionated irradiation to a total dose of 65 Gy with concomitant cisplatin and fluorouracil. Maintenance chemotherapy consisted of high-dose methotrexate and 6 cycles of epirubicin, cyclophosphamide and fluorouracil Hormonal treatment was given routinely but mastectomies were not routinely performed. A high rate of locoregional control was obtained in 47 evaluable patients of whom 93.6 % achieved a complete clinical response. Three patients had locoregional relapses, always with concomitant metastatic dissemination. In 47 patients, 21 developed metastatic dissemination with a median delay of 23 months. Median disease-free survival (DFS) was 45 months. Median overall survival (OS) has not yet been reached after a median follow-up of 44.5 months. The 3-year DFS rate was 53 % and the 3-year OS rate was 71 %. Toxicity was mainly hematological. During the induction therapy, grade 3 or 4 neutropenia occurred in 54 % of patients, grade 3 or 4 thrombocytopenia in 23 % and grade 3 or 4 anemia in 8 %. The administration of induction chemotherapy and concomitant irradiation is feasible in patients with IBC. The hematological toxicity of this treatment approach is significant but nevertheless, the treatment achieves a high degree of locoregional control and improved survivaL
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Authors | N Tubiana-Mathieu, C Lejeune, P Bonnier, D Genet, D J Adjadj, J F Berda, X Muracciole, F Delaby, P Clavere, A Benyoub, B Rhein, B Juin, L Piana |
Journal | Anticancer research
(Anticancer Res)
2001 Jul-Aug
Vol. 21
Issue 4B
Pg. 3061-7
ISSN: 0250-7005 [Print] Greece |
PMID | 11712811
(Publication Type: Journal Article)
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Chemical References |
- Antineoplastic Agents, Hormonal
- Tamoxifen
- Gonadotropin-Releasing Hormone
- Epirubicin
- Cyclophosphamide
- Vindesine
- Fluorouracil
- Methotrexate
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Topics |
- Adult
- Aged
- Antineoplastic Agents, Hormonal
(adverse effects, therapeutic use)
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects, therapeutic use)
- Breast Neoplasms
(drug therapy, mortality, pathology, radiotherapy)
- Carcinoma, Ductal, Breast
(drug therapy, mortality, pathology, radiotherapy)
- Carcinoma, Lobular
(drug therapy, mortality, pathology, radiotherapy)
- Combined Modality Therapy
- Cyclophosphamide
(administration & dosage, adverse effects)
- Disease-Free Survival
- Dose Fractionation, Radiation
- Epirubicin
(administration & dosage, adverse effects)
- Female
- Fluorouracil
(administration & dosage, adverse effects)
- Follow-Up Studies
- Gonadotropin-Releasing Hormone
(agonists)
- Hematologic Diseases
(chemically induced)
- Humans
- Life Tables
- Menopause
- Methotrexate
(administration & dosage, adverse effects)
- Middle Aged
- Neoplasm Metastasis
- Radiotherapy, Adjuvant
- Remission Induction
- Survival Analysis
- Tamoxifen
(therapeutic use)
- Thrombophlebitis
(etiology)
- Treatment Outcome
- Vindesine
(administration & dosage, adverse effects)
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