MULTIMODALITY THERAPY FOR LOCALLY ADVANCED AND LIMITED STAGE-IV BREAST-CANCER - THE IMPACT OF EFFECTIVE NON-CROSS-RESISTANT LATE-CONSOLIDATION CHEMOTHERAPY

To determine the effectiveness of non-cross-resistant late-consolidati on chemotherapy in locally advanced breast cancer (LABC) and stage IV breast cancer, we review our experience with two regimens, Between 198 5 and 1991, we enrolled 56 patients with LABC, who were treated with a doxorubicin-based adjuvant regimen, followed by a late-consolidation non-cross-resistant regimen containing methotrexate, 5-fluorouracil, c isplatin, and cyclophosphamide, Between 1985 and 1996, a total of 45 p atients with limited stage IV breast cancer underwent surgical excisio n of all evaluable disease, making them metastatic (stage IV) with no evaluable disease, Surgery was followed by a doxorubicin-containing re gimen and then a late-consolidation non-cross-resistant regimen, which was either methotrexate, 5-fluorouracil, cisplatinum, and cyclophosph amide or 5-fluorouracil, mitomycin, etoposide, and cisplatin, Twenty-f our patients with limited bone metastases that were unresectable were treated with a doxorubicin-containing regimen, radiation therapy to al l sites of disease, and then one of the two late non-cross-resistant r egimens, With a median follow-up of 84 months, 78% of patients with LA BC are alive, and 68% are free of disease, After a median follow-up of 44 months, 53% of patients with stage IV with no evaluable disease ar e alive and free of disease, The use of non-cross-resistant late-conso lidation chemotherapy is an effective strategy in the treatment of pat ients with LABC and selected patients with limited stage IV breast can cer.