NEOADJUVANT CHEMOTHERAPY WITH ACCELERATED CNF PLUS G-CSF IN PATIENTS WITH BREAST-CANCER TUMORS LARGER THAN 3 CENTIMETERS - A PILOT-STUDY

From February 1992 to November 1993, forty patients with operable brea st cancer tumors larger than three centimeters were enrolled in this s tudy of accelerated neoadjuvant chemotherapy. Thirty-seven patients ar e evaluable: one patient was excluded from the protocol and two refuse d to continue treatment after the first cycle. Chemotherapy consisted of three presurgical cycles of CNF [cyclophosphamide at 600 mg/m(2), m itoxantrone (Novantrone(C)) at 10 mg/m(2) and 5-fluorouracil at 600 mg /m(2)] administered every 2 weeks, plus G-CSF (5 mu g/kg s.c./day on d ays 7-12). Twenty-six of 37 patients (70%) achieved objective tumor re sponse and were submitted to quadrantectomy. Toxicity was easily manag eable. After a median 55-month follow-up (range 48-70), no locoregiona l recurrences were observed. Distant metastases occurred in 12/37 (32% ) patients. The five-year disease-free (DFS) and overall (OS) survival were 58% and 80%, respectively. Accelerated CNF plus G-CSF proved to be a safe and tolerable regimen yielding a good clinical response ther eby increasing the possibility of breast conservation surgery for pati ents otherwise candidates for mastectomy.