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Combined chemo‐ and hormonal therapy in advanced breast cancer
Author(s) -
Brunner K. W.,
Sonntag R. W.,
Alberto P.,
Senn H. J.,
Martz G.,
Obrecht P.,
Maurice P.
Publication year - 1977
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197706)39:6<2923::aid-cncr2820390679>3.0.co;2-3
Subject(s) - medicine , chemotherapy , hormonal therapy , prednisone , vincristine , regimen , cyclophosphamide , surgery , medroxyprogesterone acetate , hormone therapy , combination chemotherapy , breast cancer , cancer , gastroenterology , hormone
In a randomized study of 213 evaluable patients, a combination of hormone and polychemotherapy was compared with polychemotherapy alone. Three types of hormonal treatment were employed. The choice was dependent upon menopausal status or previous hormonal therapy. Forty‐two pre‐menopausal women were treated either with oophorectomy plus a modified five‐drug “Cooper” combination or with the chemotherapy regimen alone. Oral meth‐otrexate, cyclophosphamide and prednisone for two weeks was alternated with two‐week courses of I.V. fluorouracil, vincristine, and oral prednisone. Nineteen patients treated with the combined modality demonstrated a CR + PR in 74%, a minor PR in 16%, and NC + P in 10%. The respective rates in 23 premenopausal women receiving chemotherapy only were 43%, 22%, and 35%. Median time to progression was 9.5 months and median survival was 19.9 months in the combined group vs 7.8 months and 13.2 months, respectively, in the “chemotherapy only” group. Forty‐eight post‐menopausal patients without previous hormonal therapy were treated with diethylstilbestrol and the same cytostatic therapy as described; 48 patients received chemotherapy alone. CR + PR in the combined group is 63%, minor PR 21%, NC + P 16%, median remission duration 8.4 months, median survival 26.7 months. The corresponding results in the “chemotherapy only” group are 54%, 25%, and 21%, with 10.6 months median remission duration and 19.2 months median survival. Seventy‐five post‐menopausal patients with previous hormonal therapy, mainly oophorectomy (53 patients), received either chemotherapy plus a progesterone (38 patients) or cytostatic drugs only (37 patients). Results in the combined group are: CR + PR 53%, minor PR 24%, NC + P 23%; median remission duration 8.9 months, median survival 18.1 months; in the “chemotherapy only” group the corresponding figures are: 63%, 11%, 27%; 10.0 months, 22.8 months. These results are further analyzed according to dominant metastatic site, age groups, and intervals from diagnosis to the beginning of protocol therapy.