Adjuvant chemotherapy in operable breast cancer: cyclophosphamide, methotrexate, and fluorouracil versus chlorambucil, methotrexate, and fluorouracil--11-year results of Swiss Group for Clinical Cancer Research trial SAKK 27/82.

Details

Serval ID
serval:BIB_59559AE8E59D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Adjuvant chemotherapy in operable breast cancer: cyclophosphamide, methotrexate, and fluorouracil versus chlorambucil, methotrexate, and fluorouracil--11-year results of Swiss Group for Clinical Cancer Research trial SAKK 27/82.
Journal
Journal of Clinical Oncology
Author(s)
Senn H.J., Maibach R., Castiglione M., Jungi W.F., Cavalli F., Leyvraz S., Obrecht J.P., Schildknecht O., Siegenthaler P.
ISSN
0732-183X
Publication state
Published
Issued date
1997
Peer-reviewed
Oui
Volume
15
Number
7
Pages
2502-2509
Language
english
Abstract
PURPOSE: To compare two adjuvant combination chemotherapies, cyclophosphamide, methotrexate, and fluorouracil (CMF) and chlorambucil, methotrexate, and fluorouracil (LMF), for patients who had undergone potentially curative surgery for unilateral breast cancer, in terms of relapse, survival, and toxicity. PATIENTS AND METHODS: Selection criteria was as follows: stage pT1-3a, N+ or N-, M0, less than 72 years of age. Eligible patients were randomized to receive either CMF (cyclophosphamide 100 mg/m2 orally on days 1 to 14, methotrexate 40 mg/m2 intravenously (I.V.) on days 1 and 8, fluorouracil 600 mg/m2 I.V. on days 1 and 8) or LMF (Leukeran [Wellcome A.G., Bern, Switzerland] 5 mg/m2 orally on days 1 to 14 with the some I.V. cytostatic drugs). Follow-up examinations were performed every 3 months during the first 3 years after mastectomy, and every 6 months thereafter. RESULTS: A total of 246 patients were randomized, of whom 232 who were fully eligible and contribute to the analyses presented here. No statistically significant difference in favor of adjuvant CMF over LMF emerges after a median follow-up duration of 11.2 years, for either overall survival (P = .15) or disease-free survival (P = .14). A consistent trend suggestive of a possible relative benefit associated with CMF should be pointed out. However, CMF presents a significantly worse toxicity profile as concerns hematologic parameters as well as alopecia, nausea, and vomiting. CONCLUSION: This prospective trial has not identified a statistically significant difference in disease-free survival or overall survival between the two adjuvant regimens LMF and CMF. Although a trend in favor of CMF has been observed in premenopausal patients, this has to be weighted against its definitely more pronounced toxicity profile.
Keywords
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols/adverse effects, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Breast Neoplasms/drug therapy, Breast Neoplasms/metabolism, Chemotherapy, Adjuvant, Chlorambucil/administration & dosage, Cyclophosphamide/administration & dosage, Drug Administration Schedule, Female, Fluorouracil/administration & dosage, Humans, Lymphatic Metastasis, Menopause, Methotrexate/administration & dosage, Middle Aged, Switzerland, Treatment Outcome
Pubmed
Web of science
Create date
28/01/2008 8:32
Last modification date
20/08/2019 14:12
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