Toxicity of Concurrent Adjuvant CMF Chemotherapy and Radiotherapy in Patients with Early Breast Cancer

Cha-Kyong Yom; Hyun-Ah Kim; Byung-In Moon; Kuk-Jin Choe; Kum-Ja Choi; Hyun-Suk Suh; Hye-Young Choi

doi:10.4048/jbc.2007.10.2.147

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

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2007; 10(2): 147-152.

Published online: 30 June 2007

DOI: https://doi.org/10.4048/jbc.2007.10.2.147

Toxicity of Concurrent Adjuvant CMF Chemotherapy and Radiotherapy in Patients with Early Breast Cancer

Cha-Kyong Yom, Hyun-Ah Kim¹, Byung-In Moon, Kuk-Jin Choe, Kum-Ja Choi, Hyun-Suk Suh², Hye-Young Choi³

Department of Surgery, College of Medicine, Ewha Womans University, Seoul, Korea.

¹Department of Surgery, Korea Cancer Center Hospital, Seoul, Korea.

²Department of Therapeutic Radiology & Oncology, College of Medicine, Ewha Womans University, Seoul, Korea.

³Department of Radiology, College of Medicine, Ewha Womans University, Seoul, Korea.

mbit@ewha.ac.kr

Received 16 January 2007 Accepted 9 April 2007

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.

Keywords: Concurrent, CMF chemotherapy, Radiotherapy, Toxicity

Figures and Tables

Table 1

Clinicopathologic characteristics of the patients

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

Table 2

Chemotherapy related toxicity, n (%)

Table 3

Chemotherpy related hematologic toxicity, n (%)

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

Table 4

Radiation related toxicity, n (%)

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