Skip to main content
SpringerLink
Log in

Concomitant adjuvant chemotherapy and radiotherapy for high risk breast cancer patients

  • Report
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Summary

Thirty four patients treated with mastectomy and axillary node dissection for potentially curable breast cancer received a seven month combined adjuvant chemotherapy and radiation therapy program. These patients were considered to be at high risk for recurrence because they had either three or more positive axillary lymph nodes or their primary tumor was greater than 5 cm in diameter. The chemotherapy given at 3-week intervals consisted of cyclophosphamide, 600 mg/m2, Adriamycin 40mg/m2, and methotrexate 40 mg/m2 during cycles 1 through 3 and 7 through 9. Radiation therapy was administered during cycles 4 through 6 with concomitant administration of 5-fluorouracil 600 mg/m2, vincristine 1.4 mg/m2, and prednisone 40 mg/m2 for 7 days. Median follow up time from initiation of study is 60 months (range 36–93). Seventeen of 34 patients (50%) remain free of recurrent breast cancer. Distant metastases and local-regional recurrence have occurred in 16 (47%) and 4 (12%) patients, respectively. Significant myelosuppression and infections requiring hospitalization were seen in 4 patients, with 1 treatment-related death. Adriamycincontaining chemotherapy and post-operative radiotherapy can thus be combined in an adjuvant treatment program with acceptable toxicity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Margolese RG: Primary breast cancer treatment — surgery and adjuvant chemotherapy. In: Moosa AR, Robson MC, Schimpff SC (eds) Oncology. Williams and Wilkins, Baltimore, 1986, pp 968–978

    Google Scholar 

  2. Harris JR, Hellman S, Canellos GP, Fisher B: Cancer of the breast. In: DeVita VT, Hellman S, Rosenberg SA (eds) Cancer, Principles and Practice of Oncology. Lippincott, Philadelphia, 1985, pp 1119–1177

    Google Scholar 

  3. Donegan WL: Local and regional recurrence. In: Spratt JS, Donegan DL (eds) Cancer of the Breast. WB Saunders, Philadelphia, 1967, p 136

    Google Scholar 

  4. Wolmark N: The therapy of locally advanced breast cancer. In: Moosa AR, Robson MC, Schimpff SC (eds) Oncology. Williams and Wilkins, Baltimore, 1986, pp 988–1001

    Google Scholar 

  5. Valagussa P, Bonadonna G, Veronesi U: Patterns of relapse and survival following radical mastectomy. Cancer 41: 1170–1178, 1978

    PubMed  Google Scholar 

  6. Bonadonna G, Brusamolino E, Valagussa P: Combination chemotherapy as an adjuvant treatment in operable breast cancer. N Engl J Med 294: 405–410, 1976

    PubMed  Google Scholar 

  7. Fisher B, Carbone P, Economou SG: L-Phenylalanine mustard (L-PAM) in the management of primary breast cancer: A report of early findings. N Engl J Med 292: 117, 1975

    PubMed  Google Scholar 

  8. Henderson C, Canellos GP: Cancer of the breast. N Engl J Med 302: 17, 1980

    PubMed  Google Scholar 

  9. Fisher B, Slack N, Katrych DL: Ten year follow up of patients with carcinoma of the breast in a cooperative clinical trial evaluating surgical adjuvant chemotherapy. Surg Gynecol Obstet 140: 528, 1975

    PubMed  Google Scholar 

  10. Rossi A, Bonadonna G, Valagussa P: Multimodal treatment in operable breast cancer: Five-year results of the CMF programme. Br Med J 282: 1427, 1981

    Google Scholar 

  11. Buzdar A, Hortobagyi G, Smith T, Marcus C, Ames F: Ten year results of adjuvant FAC chemotherapy trial in operable breast cancer. Proc ASCO 6: 63, 1987

    Google Scholar 

  12. Perloff M, Lesnick GJ, Korzun A, Chu F, Holland JF: Combination chemotherapy with mastectomy or radiotherapy for stage III breast carcinoma: A Cancer and Leukemia Group B study. J Clin Oncol 6: 261–269, 1988

    PubMed  Google Scholar 

  13. Bonadonna G, Valagussa P, Zambetti M, Zucali R: Locally advanced breast cancer; 10-year results after combined treatment. Proc ASCO 7: 9, 1988

    Google Scholar 

  14. Swain S, Lippman M, Bagley C, Bader J, Danforth D: Treatment of locally advanced breast cancer (LABC) using primary induction chemotherapy with hormonal synchronization followed by radiation therapy with or without debulking surgery. Proc ASCO 6: 50, 1987

    Google Scholar 

  15. Hortobagyi GN, Buzdar AU, Ames FC, Montague E, Holmes FA: Preoperative chemotherapy for stage III operable breast cancer. Proc ASCO 5: 71, 1986

    Google Scholar 

  16. Hu E, Stockdale FE, Carlson RW, Levine JF, Kushlan P: Locally advanced breast cancer patients (T3/T4 or N3) treated with a sandwich approach of chemotherapy, radiotherapy, and chemotherapy. Proc ASCO 4: 58, 1985

    Google Scholar 

  17. Stefanik D, Goldberg R, Byrne P, Smith F, Ueno W: Local-regional failure in patients treated with adjuvant chemotherapy for breast cancer. J Clin Oncol 3: 600–665, 1985

    Google Scholar 

  18. Gabriel D, Bernard S, Rosenman J, Newsome J, Kober C: Local-regional recurrences in breast cancer following adjuvant chemotherapy. Proc ASCO 4: 71, 1985

    Google Scholar 

  19. Muss HB: Adjuvant irradiation following mastectomy: Where are we? J Clin Oncol 5: 1500–1501, 1987

    PubMed  Google Scholar 

  20. Coppin C, Ragaz J, Nordahl K, Jackson S: The impact of radiotherapy on adjuvant chemotherapy delivery for node positive breast cancer. Proc ASCO 7: 36, 1988

    Google Scholar 

  21. Banerjee TK, Hoehn JL, Greenlaw RH: Chemotherapy drug dosage alteration due to radiation therapy in an adjuvant situation in breast cancer. Am J Clin Oncol 7: 437–442, 1984

    PubMed  Google Scholar 

  22. Levine JF, Coleman CN, Cox RS: The effect of postoperative and primary irradiation therapy on delivered dose of adjuvant cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) chemotherapy in breast cancer. Cancer 53: 237–241, 1984

    PubMed  Google Scholar 

  23. Lee E, Desu M: A computer program for comparing K samples with right censored data. Computer Prog Biomed 2: 315–317, 1971–72

    Google Scholar 

  24. Perez CA, Presant C, Philpott G, Ratkin G: Phase I–II study of concurrent irradiation and multi-drug chemotherapy in advanced carcinoma of the breast. Int J Radiat Oncol Biol Phys 5: 1329–1333, 1979

    PubMed  Google Scholar 

  25. DeLena M, Zucali R, Viganotti G, Valagussa P, Bonadonna G: Combined chemotherapy-radiotherapy approach in locally advanced (T3b-T4) breast cancer. Cancer Chemother Pharmacol 1: 53–59, 1978

    PubMed  Google Scholar 

  26. Perloff M, Lesnick GJ, Korzun A, Chu F, Holland JF: Combination chemotherapy with mastectomy or radiotherapy for stage III breast cancer: A Cancer and Leukemia Group B study. J Clin Oncol 2: 261–269, 1988

    Google Scholar 

  27. Hortobagyi GN, Spanos W, Montague ED, Buzdar AU, Yap HY, Blumenschein GR: Treatment of locoregionally advanced breast cancer with surgery, radiotherapy, and combination chemoimmunotherapy. Int J Radiat Oncol Biol Phys 9: 643–650, 1983

    PubMed  Google Scholar 

  28. Balawajder I, Antich PP, Boland J: An analysis of the role of radiotherapy alone and in combination with chemotherapy and surgery in the management of advanced breast cancer. Cancer 51: 574–580, 1983

    PubMed  Google Scholar 

  29. DeLena M, Varini M, Zucali R: Multimodal treatment for locally advanced breast cancer: results of chemotherapyradiotherapy vs. chemotherapy-surgery. Cancer Clin Trials 4: 229–236, 1981

    PubMed  Google Scholar 

  30. Grohn P, Heinonen E, Klefstron P, Tarkkanen J: Adjuvant postoperative radiotherapy, chemotherapy, and immunotherapy in stage III breast cancer. Cancer 54: 670–674, 1984

    PubMed  Google Scholar 

  31. Montague ED, Fletcher GH: The need for every modality treatment to prevent catastrophic local and regional failures in advanced breast cancer. Int J Radiat Oncol Biol Phys 9: 419–420, 1983

    PubMed  Google Scholar 

  32. Harris JR, Sawicka J, Gelman R, Hellman S: Management of locally advanced carcinoma of the breast by primary radiation therapy. Int J Radiat Oncol Biol Phys 9: 345–349, 1983

    PubMed  Google Scholar 

  33. Hery M, Namer M, Moro M, Boublil JL, LaLanne CM: Conservative treatment (chemotherapy/radiotherapy) of locally advanced breast cancer. Cancer 57: 1744–1749, 1986

    PubMed  Google Scholar 

  34. Jacquillat C, Baillet F, Weil M, Auclerc G, Housset M: Results of a conservative treatment combining induction (neoadjuvant) and consolidation chemotherapy, hormonotherapy, and external and interstitial irradiation in 98 patients with locally advanced breast cancer IIIA-IIIB. Cancer 61: 1977–1982, 1988

    PubMed  Google Scholar 

  35. Swain SM, Sorace RA, Bagley CS, Danforth DN, Bader J: Neoadjuvant chemotherapy in the combined modality approach of locally advanced nonmetastatic breast cancer. Cancer Res 47: 3889–3894, 1987

    PubMed  Google Scholar 

  36. Cuzick J, Stewart H, Peto H, Baum M, Fisher B: Overview of randomized trials of postoperative adjuvant radiotherapy in breast cancer. Cancer Treat Rep 71: 15–25, 1987

    PubMed  Google Scholar 

  37. Griem KL, Henderson C, Gleman R, Ascoli D, Silver B: The 5-year results of a randomized trial of adjuvant radiation therapy after chemotherapy in breast cancer patients treated with mastectomy. J Clin Oncol 5: 1546–1555, 1987

    PubMed  Google Scholar 

  38. Boyages J, Langlands AO: The efficacy of combined chemotherapy and radiotherapy in advanced non-metastatic breast cancer. Int J Radiat Oncol Biol Phys 14: 71–78, 1988

    PubMed  Google Scholar 

Download references

Author information

Author notes

  1. R. Komaki & J. Cox

    Present address: University of Texas, MD Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, TX, USA

Authors and Affiliations

  1. Section of Hematology/Oncology, Department of Medicine, and the Department of Radiation Therapy, The Medical College of Wisconsin, 8700 W. Wisconsin Avenue, Box 133, 53226, Milwaukee, WI, USA

    R. Hansen, B. Erickson, R. Komaki, N. Janjan, J. Cox, J. F. Wilson & T. Anderson

Authors
  1. R. Hansen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Erickson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Komaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Janjan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Cox
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. F. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. T. Anderson
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hansen, R., Erickson, B., Komaki, R. et al. Concomitant adjuvant chemotherapy and radiotherapy for high risk breast cancer patients. Breast Cancer Res Tr 17, 171–177 (1991). https://doi.org/10.1007/BF01806366

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01806366

Key words

Search

Navigation