FEASIBILITY STUDY OF FEC-CHEMOTHERAPY WITH DOSE-INTENSIVE EPIRUBICIN AS INITIAL TREATMENT IN HIGH-RISK BREAST-CANCER

Background: The prognosis of patients with stage III B breast carcinom a with metastasis to the apical axillary lymph nodes is poor despite a dequate local control achieved by surgery and/or radiation therapy Thi s study evaluated the feasibility of a dose-intensive up-front chemoth erapy regimen in this subgroup of patients. Patients and methods: A pr eoperative chemotherapy regimen consisting of 3 courses of fluorouraci l 500 mg/m2, dose-intensive epidoxorubicin 120 mg/m2 and cyclophospham ide 500 mg/m2 (DIE-FEC), was administered at 21-day intervals without hematopoietic growth factors to 31 patients with apex-positive disease . All patients were below 60 years of age and none had had prior chemo therapy or radiotherapy Results: Seven patients achieved clinical comp lete responses (23%), and 21 achieved clinical partial responses (68%) ; three patients had stable disease (10%), one of whom had only ductal carcinoma in situ at histopathologic evaluation, which suggested an a dditional response to therapy. The major toxicity was moderate bone ma rrow suppression with a median WBC nadir of 1650/mul (range 500-4600). Other toxic effects were mild. Conclusion: DIE-FEC is well-tolerated and highly effective as up-front chemotherapy in relatively young pati ents with high-risk breast cancer, with a 90% (CI 74%-98%) clinical ob jective response rate.