Primaire hoog gedoseerde chemotherapie met hematopoëtische groeifactoren gevolgd door chirurgie en radiotherapie bij stadium III-mammacarcinoom; een fase II-onderzoek bij 15 patiënten

Translated title of the contribution: Primary high-dose chemotherapy with hematopoietic growth factors followed by surgery and radiotherapy in stage III breast carcinoma; a Phase II study in 15 patients

K Hoekman, J Wagstaff, J B Vermorken, S Meijer, O W Meijer, H M Pinedo

Research output: Contribution to journalArticleAcademicpeer-review


OBJECTIVE: To establish if the prognosis of a stage III breast carcinoma is improved by primary high-dose chemotherapy in combination with haemopoietic growth factors, followed by radical surgery and radiotherapy.

DESIGN: Phase II study.

SETTING: University Hospital Free University, Amsterdam.

METHOD: Fifteen patients with a locally advanced breast carcinoma (stages IIIA or IIIB) were treated every three weeks with doxorubicin 90 mg/sq.m. and cyclophosphamide 1000 mg/sq.m., followed by granulocyte-macrophage colony-stimulating factor (GM-CSF) 250 micrograms/sq.m. from day 2 up to and including day 12. After 4-6 of these courses the treatment in principle was continued with a modified radical mastectomy, followed by radiotherapy. Median duration of follow-up was 18 months.

RESULTS: All tumours were reduced by over 50%. 10/15 Patients went into clinical complete remission; in 6/9 of these, pathological examination revealed only microscopical tumour rests, in the other three the rest diameter was < or = 1 cm. The haematological toxicity was mild. Grade III-IV bone marrow suppression was followed by rapid return to normal of the numbers of neutrophil granulocytes and thrombocytes under the influence of GM-CSF. The non-haematological toxicity manifested itself with nausea and vomiting, stomatitis and mild side effects attributable to GM-CSF.

CONCLUSION: It appears justified in the treatment of locally advanced breast carcinoma to start with chemotherapy. Dose escalation of efficacious chemotherapeutics resulted in a large number of complete remissions.

Original languageDutch
Pages (from-to)1069-73
Number of pages5
JournalNederlands Tijdschrift voor Geneeskunde
Issue number21
Publication statusPublished - 21 May 1994

Cite this