No abstract

One hundred forty-one patients with advanced breast cancer who had not received prior chemotherapy were randomly assigned to receive doxorubicin 60 mg/m2 or epirubicin 90 mg/m2 every 3 weeks. These doses were selected to produce equivalent toxicities. All patients were assessed for toxicity, and 138 patients were assessable for response. After a median of five treatment cycles, 47% (32 of 68) of doxorubicin-treated patients achieved a partial or complete response. Response duration and survival were 10 and 12 months for doxorubicin and 8 and 10 months for epirubicin, respectively. Noncardiac toxicities were similar for both drugs. Of 41 patients receiving doxorubicin who had serial left ventricular ejection fraction assessments, seven sustained a fall of 10% or more, and one patient developed congestive cardiac failure at a cumulative doxorubicin dose of 489 mg/m2. Of 39 patients receiving epirubicin who had serial cardiac assessments, five sustained left ventricular ejection fraction falls of 10% or more and two patients developed congestive cardiac failure at cumulative doses of 178 mg/m2 and 833 mg/m2. These data indicate that an epirubicin dose of 90 mg/m2 produces toxicity equivalent to doxorubicin 60 mg/m2 but does not improve response rates, response duration, or survival in advanced breast cancer.

Objective To re-evaluate a national prospective study in for relapse in this series. Only one relapse occurred >28 months after orchidectomy. Despite poor comNew Zealand after 17 years to define whether orchidectomy alone and surveillance for nonseminoma pliance in some patients (12%) their survival was not prejudiced. Three patients died from disease despite germ cell testicular tumour (NSGCTT) is a sound policy and matches the results achieved by other chemotherapy at relapse. At 17 years and a median follow-up of 53 months, 242 of the 248 men are treatment protocols. Patients and methods Between 1980 and 1997, 248 disease-free and the disease-specific survival rate is 98%. men with stage I NSGCTT, from six New Zealand centres, were managed by orchidectomy alone and Conclusions This study shows that orchidectomy alone and treatment of relapses produces excellent longsurveillance, with treatment of relapses using combination chemotherapy.term results without the adverse eCects associated with retroperitoneal node dissection or elective chemoResults Seventy of the 248 patients (28%) relapsed; 42 of 92 (46%) with vascular and/or lymphatic invasion therapy for high-risk cases. Keywords Stage I nonseminoma, testicular cancer, (VLI) in the primary tumour relapsed, whereas only 26 of 151 (17%) without this feature relapsed surveillance, long-term follow-up, orchidectomy (P<0.001). VLI was the only identifiable risk factor ommend that high-risk patients should be oCered adju-