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. 1994 Dec;70(6):1258–1262. doi: 10.1038/bjc.1994.483

S-phase fraction and survival benefit from adjuvant chemotherapy or radiotherapy of breast cancer.

O Stål 1, L Skoog 1, L E Rutqvist 1, J M Carstensen 1, S Wingren 1, S Sullivan 1, A C Andersson 1, M Dufmats 1, B Nordenskjöld 1
PMCID: PMC2033711  PMID: 7981085

Abstract

Cancer chemotherapy interacts with cell proliferation, but data on the relationship between cancer cell replication and the effect of adjuvant chemotherapy are scarce. We have investigated the S-phase fractions of the primary tumour from premenopausal breast cancer patients who participated in a randomised trial comparing 12 cycles of polychemotherapy (CMF) with post-operative radiotherapy. DNA flow cytometry was performed on frozen tissues from 208 primary breast carcinomas, of which the S-phase fraction was estimated in 176 cases. There was a significantly higher benefit from CMF among patients with a high S-phase fraction (P = 0.0033). The relative risk of distant recurrence or death in the chemotherapy group as compared with the radiotherapy group was 0.19 for patients whose tumours had an S-phase fraction of 10% or over (95% CI 0.07-0.51) and 1.55 (0.88-2.73) for patients whose tumours showed lower S-phase levels. The interaction was still significant in multivariate analysis (P = 0.0057), including lymph node metastases, tumour size and oestrogen receptor content. We conclude that the benefit from adjuvant chemotherapy compared with radiotherapy is largely confined to patients with highly proliferative tumours.

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Selected References

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