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Efficacy of postoperative adjuvant therapy for stage ilia breast cancer: Futraful vs futraful+tamoxifen for er-positive patients and futraful vs futraful + adriamycin for er-negative breast cancer

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Abstract

A multi-center, randomized controlled collaborative study was conducted in 310 institutions located throughout Japan for 3 years and 9 months from February 1985 until October 1988 to evaluate the efficacy of post-operative adjuvant therapy for patients who had previously undergone curative surgery for treatment of Stage IIIa breast cancer. Patients with estrogen receptor-positive [ER( + )] breast cancer were treated with two types of regimens, ie, cyclophosphamide + adriamycin + fluorouracil (CAF; 2 cycles) + Futraful (FT) or CAF (2 cycles) + FT + tamoxifen (TAM), and the clinical benefit of additional use of TAM was evaluated. Of the 509 ER( + ) patients registered for the trial, 473 patients (92.9%) were eligible for evaluation. The 5-year survival rate was 77.2% for the CAF + FT group and 74.6% for the CAF + FT+TAM group, and the 5-year disease-free survival rate was 56.7% for the CAF+FT group and 59.2% for the CAF + FT + TAM group. Neither the survival rate nor the disease-free survival rate differed significantly between the groups. Analyses by factor revealed that the 5-year disease-free rate for lymph node-negative patients in the CAF + FT + TAM group was significantly higher than that for the corresponding patients in the CAF + FT group. No differences were noted in the incidence of adverse reactions between the two treatment groups, other than an increase in LDH (the frequency of which was higher in the CAF + FT+TAM group than in the CAF + FT group). Patients with estrogen receptor-negative [ER( -)] breast cancer were treated with two types of regimens, ie, CAF + FT or CAF + FT + adriamycin (ADR), and the clinical benefit of the combined use of intermittent doses of ADR was evaluated. Of the 514 ER(-) patients registered in the trial, 478 (93.0%) were eligible for evaluation. The 5-year survival rate was 64.9% for the CAF + FT group and 63.0% for the CAF + FT + ADR group, and the 5-year disease-free survival rate was 59.2% for both CAF + FT and CAF + FT + ADR groups. Neither the survival rate nor the disease-free survival rate differed significantly between the groups. There were no significant differences between these groups in analyses by nodal or menopausal status. The incidences of adverse reactions including anorexia, nausea/vomiting and alopecia were higher in the CAF + FT+ADR group than in the CAF + FT group.

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Abbreviations

ACETBC:

Adjuvant Chemoendocrine Therapy for Breast Cancer

ER:

Estrogen receptor

TAM:

Tamoxifen

FT:

Futraful

ADR:

Adriamycin

CAF:

Cyclophosphamide + adriamycin + fluorouracil

CMF:

Cyclophosphamide + methotrexate + fluorouracil

MMC:

Mitomycin-C

EBCTCG:

Early Breast Cancer Trialists’ Collaborative Group

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Authors and Affiliations

  1. Aichi Cancer Center Hospital, Chief Investigator of the Chubu Region, 1-1, Kanokoden, 464, Chikusa-ku, Nagoya, Japan

    Minoru Yoshida

  2. St. Luke’s International Hospital, Chairman of ACETBC and Chief Investigator of the Kanto Region, Japan

    Osahiko Abe

  3. The First Department of Surgery, Hokkaido University School of Medicine, Chief Investigator of the Hokkaido Region, Japan

    Junichi Uchino

  4. Sendai National Hospital, Chief Investigator of the Tohoku Region, Japan

    Kaneo Kikuchi

  5. The Second Department of Surgery, Fukushima Medical College, Administrator of Tohoku Region, Japan

    Rikiya Abe

  6. Department of Surgery, School of Medicine, Keio University, Deputy Investigator of Organizing and Steering Committee of the Kanto Region, Japan

    Kohji Enomoto

  7. Tokyo Metropolitan Komagome Hospital, Chairman of Organizing and Steering Committee of the Kanto Region, Japan

    Takeshi Tominaga

  8. Kameda General Hospital, Investigator of Organizing and Steering Committee of the Kanto Region, Japan

    Atsuo Fukami

  9. The Second Department of Surgery, Osaka City University Medical School, Chief Investigator of Kinki Region, Japan

    Katsuharu Sakai

  10. The Center for Adult Diseases, Osaka, Chairman of Organizing and Steering Committee of the Kinki Region, Japan

    Hiroki Koyama

  11. Second Department of Surgery, Faculty of Medicine, Kyushu University, Co-chief Investigator of Nishinihon Region, Japan

    Keizo Sugimachi

  12. National Kyushu Cancer Center Hospital, Co-Chief Investigator of Nishinihon Region, Japan

    Asuo Nomura

  13. Hiroshima University, Former Chief Investigator of Nishinihon Region, Japan

    Takao Hattori

  14. Ehime University, Controller, Japan

    Nobuya Ogawa

Authors
  1. Minoru Yoshida
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  2. Osahiko Abe
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  3. Junichi Uchino
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  4. Kaneo Kikuchi
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  5. Rikiya Abe
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  6. Kohji Enomoto
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  7. Takeshi Tominaga
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  8. Atsuo Fukami
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  9. Katsuharu Sakai
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  10. Hiroki Koyama
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  11. Keizo Sugimachi
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  12. Asuo Nomura
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  13. Takao Hattori
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  14. Nobuya Ogawa
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Yoshida, M., Abe, O., Uchino, J. et al. Efficacy of postoperative adjuvant therapy for stage ilia breast cancer: Futraful vs futraful+tamoxifen for er-positive patients and futraful vs futraful + adriamycin for er-negative breast cancer. Breast Cancer 4, 103–113 (1997). https://doi.org/10.1007/BF02967063

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  • DOI: https://doi.org/10.1007/BF02967063

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