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Titolo:
Stage III and oestrogen receptor negativity are associated with poor prognosis after adjuvant high-dose therapy in high-risk breast cancer
Autore:
Hohaus, S; Funk, L; Martin, S; Schlenk, RF; Abdallah, A; Hahn, U; Egerer, G; Goldschmidt, H; Schneeweiss, A; Fersis, N; Kaul, S; Wallwiener, D; Bastert, G; Haas, R;
Indirizzi:
Univ Heidelberg, Dept Internal Med 5, D-69115 Heidelberg, Germany Univ Heidelberg Heidelberg Germany D-69115 , D-69115 Heidelberg, Germany Univ Heidelberg, Dept Gynaecol, Heidelberg, Germany Univ Heidelberg Heidelberg Germany , Dept Gynaecol, Heidelberg, Germany German Canc Res Ctr, Clin Cooperat Unit, Heidelberg, Germany German Canc Res Ctr Heidelberg Germany operat Unit, Heidelberg, Germany
Titolo Testata:
BRITISH JOURNAL OF CANCER
fascicolo: 9-10, volume: 79, anno: 1999,
pagine: 1500 - 1507
SICI:
0007-0920(199903)79:9-10<1500:SIAORN>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MARROW TRANSPLANTATION; STEM-CELL SUPPORT; PROGENITOR CELLS; CHEMOTHERAPY; SURVIVAL; RELAPSE; CARBOPLATIN; MASTECTOMY; LYMPHOMA; NODES;
Keywords:
breast cancer; high-dose chemotherapy; peripheral blood stem cell transplantation; prognostic indicators; tumour cells;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Hohaus, S Univnyeidelberg, Dept Internal Med 5, Hosp Str 3, D-69115 Heidelberg, Germa Univ Heidelberg Hosp Str 3 Heidelberg Germany D-69115 rg, Germa
Citazione:
S. Hohaus et al., "Stage III and oestrogen receptor negativity are associated with poor prognosis after adjuvant high-dose therapy in high-risk breast cancer", BR J CANC, 79(9-10), 1999, pp. 1500-1507

Abstract

We report on the efficacy and toxicity of a sequential high-dose therapy with peripheral blood stem cell (PBSC) support in 85 patients with high-riskstage II/III breast cancer. There were 71 patients with more than nine tumour-positive axillary lymph nodes. An induction therapy of two cycles of ifosfamide (total dose, 7.5 g m(-2)) and epirubicin (120 mg m-2) was given, and PBSC were harvested during G-CSF-supported leucocyte recovery following the second cycle. The PBSC-supporied high-dose chemotherapy consisted of two cycles of ifosfamide (total dose, 12 000 mg m(-2)), carboplatin (900 mg m-2) and epirubicin (180 mg m(-2)). Patients were autografted with a median number of 3.7 x 10(6) CD34+ cells kg(-1) (range, 1.9-26.5 x 10(6)) resulting in haematological reconstitution within approximately 2 weeks following high-dose therapy. The toxicity was moderate in general, and there was no treatment-related toxic death. Twenty-one patients relapsed between 3 and 30 months following the last cycle of high-dose therapy (median, 11 months). The probability of disease-free and overall survival at 4 years were 60% and83%, respectively. According to a multivariate analysis, patients with stage II disease had a significantly better probability of disease-free survival (74%) in comparison to patients with stage III disease (36%). The probability of disease-free survival was also significantly better for patients with oestrogen receptor-positive tumours (70%) compared to patients with receptor-negative ones (40%), Bone marrow samples collected from 52 patients after high-dose therapy were examined to evaluate the prognostic relevance of isolated tumour cells. The proportion of patients presenting with tumour cell-positive samples did not change in comparison to that observed before high-dose therapy (65% vs 71%), but a decrease in the incidence and concentration of tumour cells was observed over time after high-dose therapy. Thisfinding was true for patients with relapse and for those in remission, which argues against a prognostic significance of isolated tumour cells in bone marrow. In conclusion, sequential high-dose chemotherapy with PBSC support can be safely administered to patients with high-risk stage II/III breastcancer. Further intensification of the therapy, including the addition of non-cross resistant drugs or immunological approaches such as the use of antibodies against HER-2/NEU, may be envisaged for patients with stage ill disease and hormone receptor-negative tumours.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 22:13:42