CMF PLUS RADIOTHERAPY IN THE PRIMARY-TREATMENT OF OPERABLE BREAST-CANCER - PRELIMINARY-RESULTS OF A PHASE-II PILOT-STUDY

Background and Objectives: Chemotherapy and radiotherapy have been inv estigated in several studies about their role in primary (neoadjuvant) treatment before surgery in breast cancer. We proposed a pilot study to evaluate a primary scheme of alternate radio-chemotherapy in the tr eatment of operable (T2- small T3) breast cancer. Methods: 14 patients were recruited. Cyclophosphamide, methotrexate, and 5-fluorouracil (C MF) were administered on days 1 and 8, every 4 wk, for two cycles. Rad iotherapy was administered during the 3rd and 4th wk (5 d/wk) after th e beginning of chemotherapy. The patients were operated on within 2-4 wk. All the patients received four additional cycles of chemotherapy w ithin 1 mo after surgery. Results: We observed: 1 (8.3%) complete remi ssion (CR), 8 (66.7%) partial remission (PR), 3 (25%) stationary disea se (SD); no progressive disease was observed. Modified radical mastect omy was performed on 7 patients (58.3%). Conservative surgery was perf ormed on 5 cases (41.7%). No major complications were observed. No pat ient has shown local or distant recurrence. Conclusions: This study sh ows the feasibility of a primary chemoradiotherapy treatment for breas t cancer. But to evaluate the impact of this therapy on overall surviv al and recurrence risk and its possible introduction in clinical pract ice, we need larger series and longer follow-up. (C) 1998 Wiley-Liss, Inc.