Journal List > J Breast Cancer > v.10(2) > 1036062

Yom, Kim, Moon, Choe, Choi, Suh, and Choi: Toxicity of Concurrent Adjuvant CMF Chemotherapy and Radiotherapy in Patients with Early Breast Cancer

Abstract

Purpose

Many patients with early stage breast cancer are currently being treated with both adjuvant chemotherapy (CT) and radiotherapy (RT). We performed this study to assess the toxicity of concurrent adjuvant cyclophosphamide, methotrexate, and 5-fluourouracil (CMF) CT and RT for treating early breast cancer patients.

Methods

Between January 2000 and December 2005, 97 patients with stage I or II invasive breast carcinoma were treated with breast-conserving surgery, and they received 6 monthly cycles of classic oral chemotherapy with CMF. Within day 7 of cycle 1, the patients started 3 dimensional conformal RT (3DCRT) with a stadard dose, followed by a boost. We used the Common Terminology Criteria for Adverse Events v 3.0 to score the level of acute toxicity for CT. The adverse effects of RT were graded according to the Radiation Therapy Oncology Group criteria.

Results

The mean age of the patients was 45.8 yr (range: 30-64). The most common toxicity was nausea and leukopenia. The dose of chemotherapy was reduced to 80% of the planned dose for 6.2% of the patient. CT was disrupted for 4.1% of the patients. RT was not disrupted for any patient. Grade 3 and 4 neutropenia occurred in 41 (42.3%) patients, but only one patient needed hospitalization due to fever. Grade 3 skin lesions developed during or shortly after RT in 10.7% of the patients. Radiation penumonitis was noted in 15.5% of the patients. The median follow-up time was 38 months. There was no local recurrence and 2 (2.08%) distant metastases during follow-up.

Conclusion

From the results of our study, we conclude that the concurrent administration of adjuvant CMF CT and RT is associated with a low risk of serious toxicity and this is an acceptable adjuvant regimen for patients with early stage breast cancer.

Figures and Tables

Table 1
Clinicopathologic characteristics of the patients
jbc-10-147-i001

NOS, not otherwise specified; ER, Estrogen receptor; PR, Progesterone receptor; SNB, Sentinel node biopsy; AND, Axillary node dissection.

Table 2
Chemotherapy related toxicity, n (%)
jbc-10-147-i002
Table 3
Chemotherpy related hematologic toxicity, n (%)
jbc-10-147-i003

ANC, absolute neutrophil count; AST, aspartate transminase; ALT, alanine transaminase.

Table 4
Radiation related toxicity, n (%)
jbc-10-147-i004

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