Intravenous or Oral Adjuvant CMF for Node‐positive Breast Cancer

Lindeman, Geoffrey J.; Boyages, John; Driessen, Carla; Langlands, A.O.

doi:10.1111/j.1445-2197.1992.tb07050.x

Cited by 12 publications

(6 citation statements)

References 14 publications

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“…As G-CSF should not be given simultaneously with chemo therapy, a shorter interval is hardly feasible with the use of oral cyclophosphamide given for 2 weeks. In patients with metastatic disease, a 3-weekly lower dose intensity intravenous CMF schedule proved to be inferior to the oral schedule [16,17]. For this reason, we choose to main tain the 'classical' oral schedule.…”

Section: Discussionmentioning

confidence: 99%

Dose Intensity of Standard Adjuvant CMF with Granulocyte Colony-Stimulating Factor for Premenopausal Patients with Node-Positive Breast Cancer

Graaf¹,

Willemse²,

Bong

et al. 1996

Oncology

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The effects of granulocyte colony-stimulating factor (G-CSF) on total dose and dose intensity of standard oral adjuvant CMF (cyclophosphamide, methotrexate, and 5-fluorouracil) chemotherapy were studied in premenopausal patients with node-positive breast cancer. Treatment consisted of standard CMF and locoregional radiotherapy (on indication). G-CSF was administered if the leukocyte count recovery was insufficient. Fifty-one patients required no G-CSF (‘no cytopenia’), and 50 patients received G-CSF (‘G-CSF’). Twenty-two patients, however, received no G-CSF support despite insufficient leukocyte recovery (‘control’). Following G-CSF, leukocyte recovery was adequate in 83% of the chemotherapy cycles. The proportion of the patients who had a dose intensity > 85% was 90% in the ‘no cytopenia’ group, 74% in the ‘G-CSF’ group, and 45% in the ‘control’ group (p < 0.05). Leukocyte recovery was adequate in 87% of the chemotherapy cycles in the patients who received radiotherapy as compared with 92% of those in the patients without radiotherapy (p < 0.05). In conclusion an adequate leukocyte recovery after G-CSF was found in 83% of all chemotherapy cycles. The dose intensity of the G-CSF group was higher as compared with controls. The impact of radiotherapy on hematological recovery was significant, but not dependent on G-CSF.

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Section: Discussionmentioning

confidence: 99%

Dose Intensity of Standard Adjuvant CMF with Granulocyte Colony-Stimulating Factor for Premenopausal Patients with Node-Positive Breast Cancer

Graaf¹,

Willemse²,

Bong

et al. 1996

Oncology

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“…dose from day 8 onwards and thus shorten the interval between the cycles. Several studies examining the route of administration have been published (Engelsman et al, 1991;Lindeman et al, 1992). An EORTC randomized study has compared 'classical' CMF with i.v.…”

Section: Discussionmentioning

confidence: 99%

True

et al. 2000

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Summary Our aim was to study the feasibility of an intensified intravenous CMF (cyclophosphamide, methotrexate and 5-fluorouracil) schedule with the aim to escalate dose intensity (DI). Twenty-three premenopausal breast cancer patients received 6 cycles of adjuvant CMF intravenously on days 1 and 8 every 3 weeks and granulocyte colony-stimulating factor days 9-18. Endpoints were DI and toxicity. Twentyone out of 23 patients (91%) received the projected total dose and reached ≥ 85% of the projected DI. Compared to 'classical' CMF, all patients reached ≥ 111% DI. Nine patients received the planned schedule without delay. Thirteen patients (57%) were treated for infection and four patients (17%) were hospitalized for febrile neutropenia. Twelve patients received red blood cell transfusions (52%). Radiation therapy (n = 6) had no adverse impact on dose intensity or haematological toxicity. This dose-intensified CMF schedule was accompanied by enhanced haematological toxicity with clinical sequelae, namely fever, intravenous antibiotics and red blood cell transfusions, but allows a high dose intensity in a majority of patients.

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“…The most commonly used regimen was six cycles of intravenous CMF consisting of cyclophosphamide, 600 mg/m 2 , methotrexate, 40 mg/m 2 and 5‐fluorouracil, 600 mg/m 2 (i.v. CMF) given every 21 days as described elsewhere 16 . Adjuvant Tamoxifen (20 mg daily for 2–5 years) was administered to 13 patients of whom seven were node‐positive and three had undissected axillae.…”

Section: Methodsmentioning

confidence: 99%

“…CMF) given every 21 days as described elsewhere. 16 Adjuvant Tamoxifen (20 mg daily for 2-5 years) was administered to 13 patients of whom seven were node-positive and three had undissected axillae.…”

Section: Methodsmentioning

confidence: 99%