Neoadjuvant chemotherapy in locally advanced breast cancer: A preliminary report

Aims and background: A pilot study of neoadjuvant chemotherapy with cycloph osphamide-epirubicin-5-fluorouracil (FEC) was performed on 85 patients with locally advanced breast cancer. Methods and study design: Patients received four cycles of neoadjuvant chem otherapy followed by surgery, radiotherapy and a treatment with cyclophosph amide-methotrexate-5-fluorouracil for three cycles. Results; Major clinical response was obtained in 76 (89%) patients. Complet e response was documented in 14 (17%) patients at pathologic examination of surgical specimen. Grade 1-2 nausea and vomiting was the most common (77%) side effect. Grade 2-3 alopecia was 66%, Grade 2-3 neutropenia occurred in 16% of patients. None of the patients developed febrile neutropenia. Sinus tachycardia was observed only in one patient. Three patients had a more th an 10% decrease in the left ventricular ejection fraction without any clini cal signs. Nine patients had progressive or stable disease and 4 did not un dergo surgery or receive radiation therapy; thus 13 were excluded from surv ival analysis. After a median followup of 31 months (range, 15-41), disease -free survival and overall survival were 20 (range, 13-32) and 23 months (r ange, 17-32). Conclusions: The FEC combination is safe and effective for a neoadjuvant se tting in locally advanced breast cancer. A longer follow-up is necessary fo r the end point results.