Skip to main content
British Journal of Cancer logoLink to British Journal of Cancer
. 1992 May;65(5):761–765. doi: 10.1038/bjc.1992.160

Locally advanced breast cancer: report of phase II study and subsequent phase III trial.

A Rodger 1, W J Jack 1, P D Hardman 1, G R Kerr 1, U Chetty 1, R C Leonard 1
PMCID: PMC1977400  PMID: 1586604

Abstract

Twenty-four evaluable patients with stage T4 breast cancer were entered into a phase II study and received chemotherapy comprising cyclophosphamide 1,000 mg m-2 i.v., doxorubicin 50 mg m-2 i.v., vincristine 1.4 mg m-2 i.v. and prednisolone 40 mg orally for 5 days, given 3 weekly for four cycles prior to undergoing loco-regional radiotherapy. All patients completed treatment as planned with no major acute toxicity from either chemotherapy or radiotherapy. Subsequently 52 patients with stage T4 breast cancer were randomised in a phase III trial to receive either radiotherapy alone (RT) or this chemotherapy and radiotherapy (CHOP + RT). A significantly higher complete response rate was achieved in the CHOP + RT treatment arm (P = 0.03). However a larger proportion of the RT arm achieved loco-regional control after salvage treatment for relapse such that 50% of the RT arm and 57% of the CHOP + RT arm had no evidence of loco-regional disease at the time of last follow-up or death. There was no statistical difference in time to distant relapse or overall survival. Analysis of the pilot study showed results comparable to the trial CHOP + RT arm. This trial suggests that this cytotoxic therapy used in conjunction with radiotherapy has only marginal value in improving prognosis in locally advanced breast cancer.

Full text

PDF
763

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bull J. M., Tormey D. C., Li S. H., Carbone P. P., Falkson G., Blom J., Perlin E., Simon R. A randomized comparative trial of adriamycin versus methotrexate in combination drug therapy. Cancer. 1978 May;41(5):1649–1657. doi: 10.1002/1097-0142(197805)41:5<1649::aid-cncr2820410501>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  2. De Lena M., Zucali R., Viganotti G., Valagussa P., Bonadonna G. Combined chemotherapy-radiotherapy approach in locally advanced (T3b-T4) breast cancer. Cancer Chemother Pharmacol. 1978;1(1):53–59. doi: 10.1007/BF00253147. [DOI] [PubMed] [Google Scholar]
  3. GRISCOM N. T., WANG C. C. Radiation therapy of inoperable breast carcinoma. Radiology. 1962 Jul;79:18–23. doi: 10.1148/79.1.18. [DOI] [PubMed] [Google Scholar]
  4. Gröhn P., Heinonen E., Klefström P., Tarkkanen J. Adjuvant postoperative radiotherapy, chemotherapy, and immunotherapy in stage III breast cancer. Cancer. 1984 Aug 15;54(4):670–674. doi: 10.1002/1097-0142(1984)54:4<670::aid-cncr2820540414>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  5. Hayward J. L., Carbone P. P., Heuson J. C., Kumaoka S., Segaloff A., Rubens R. D. Assessment of response to therapy in advanced breast cancer: a project of the Programme on Clinical Oncology of the International Union Against Cancer, Geneva, Switzerland. Cancer. 1977 Mar;39(3):1289–1294. doi: 10.1002/1097-0142(197703)39:3<1289::aid-cncr2820390340>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  6. Hryniuk W., Bush H. The importance of dose intensity in chemotherapy of metastatic breast cancer. J Clin Oncol. 1984 Nov;2(11):1281–1288. doi: 10.1200/JCO.1984.2.11.1281. [DOI] [PubMed] [Google Scholar]
  7. Langlands A. O., Kerr G. R., Shaw S. The management of locally advanced breast cancer by X-ray therapy. Clin Oncol. 1976 Dec;2(4):365–371. [PubMed] [Google Scholar]
  8. Lopez M. J., Kraybill W. G., Reynolds R. D., Khojasteh A. Changing patterns in the management of locally advanced breast cancer: a preliminary report. Can J Surg. 1985 Jul;28(4):319–321. [PubMed] [Google Scholar]
  9. Loprinzi C. L., Carbone P. P., Tormey D. C., Rosenbaum P. R., Caldwell W., Kline J. C., Steeves R. A., Ramirez G. Aggressive combined modality therapy for advanced local-regional breast carcinoma. J Clin Oncol. 1984 Mar;2(3):157–163. doi: 10.1200/JCO.1984.2.3.157. [DOI] [PubMed] [Google Scholar]
  10. Lyss A. P., Loeb V., Jr Chemotherapy of advanced breast cancer. A general survey. Cancer. 1984 Feb 1;53(3 Suppl):778–782. doi: 10.1002/1097-0142(19840201)53:3+<778::aid-cncr2820531328>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  11. Rainey J. M., Jones S. E., Salmon S. E. Combination chemotherapy for advanced breast cancer utilizing vincristine, adriamycin, and cyclophosphamide (VAC). Cancer. 1979 Jan;43(1):66–71. doi: 10.1002/1097-0142(197901)43:1<66::aid-cncr2820430109>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  12. Roberts M. M., Alexander F. E., Elton R. A., Rodger A. Breast cancer stage, social class and the impact of screening. Eur J Surg Oncol. 1990 Feb;16(1):18–21. [PubMed] [Google Scholar]
  13. Rubens R. D., Armitage P., Winter P. J., Tong D., Hayward J. L. Prognosis in inoperable stage III carcinoma of the breast. Eur J Cancer. 1977 Aug;13(8):805–811. doi: 10.1016/0014-2964(77)90134-7. [DOI] [PubMed] [Google Scholar]
  14. Rubens R. D., Bartelink H., Engelsman E., Hayward J. L., Rotmensz N., Sylvester R., van der Schueren E., Papadiamantis J., Vassilaros S. D., Wildiers J. Locally advanced breast cancer: the contribution of cytotoxic and endocrine treatment to radiotherapy. An EORTC Breast Cancer Co-operative Group Trial (10792). Eur J Cancer Clin Oncol. 1989 Apr;25(4):667–678. doi: 10.1016/0277-5379(89)90203-4. [DOI] [PubMed] [Google Scholar]
  15. Rubens R. D., Sexton S., Tong D., Winter P. J., Knight R. K., Hayward J. L. Combined chemotherapy and radiotherapy for locally advanced breast cancer. Eur J Cancer. 1980 Mar;16(3):351–356. doi: 10.1016/0014-2964(80)90352-7. [DOI] [PubMed] [Google Scholar]
  16. Schaake-Koning C., van der Linden E. H., Hart G., Engelsman E. Adjuvant chemo- and hormonal therapy in locally advanced breast cancer: a randomized clinical study. Int J Radiat Oncol Biol Phys. 1985 Oct;11(10):1759–1763. doi: 10.1016/0360-3016(85)90028-8. [DOI] [PubMed] [Google Scholar]
  17. Spanos W. J., Jr, Montague E. D., Fletcher G. H. Late complications of radiation only for advanced breast cancer. Int J Radiat Oncol Biol Phys. 1980 Nov;6(11):1473–1476. doi: 10.1016/0360-3016(80)90002-4. [DOI] [PubMed] [Google Scholar]
  18. THOMLINSON R. H., GRAY L. H. The histological structure of some human lung cancers and the possible implications for radiotherapy. Br J Cancer. 1955 Dec;9(4):539–549. doi: 10.1038/bjc.1955.55. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Zucali R., Uslenghi C., Kenda R., Bonadonna G. Natural history and survival of inoperable breast cancer treated with radiotherapy and radiotherapy followed by radical mastectomy. Cancer. 1976 Mar;37(3):1422–1431. doi: 10.1002/1097-0142(197603)37:3<1422::aid-cncr2820370325>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES