Cancer Res Treat.  2005 Jun;37(3):137-142.

High-Dose Chemotherapy of Cyclophosphamide, Thiotepa and Carboplatin (CTCb) followed by Autologous Stem-Cell Transplantation as a Consolidation for Breast Cancer Patients with 10 or more Positive Lymph Nodes: a 5-Year follow-Up Results

• Sohn HJ
• Kim SH
• Lee GW
• Kim S
• Ahn JH
• Kim SB
• Kim SW
• Kim WK
• Suh C

Abstract

PURPOSE
The benefit of consolidation high-dose chemotherapy (HDC) for high-risk primary breast cancer is controversial. We evaluated the efficacy and safety of consolidation HDC with cyclophosphamide, thiotepa and carboplatin (CTCb) followed by autologous stem-cell transplantation (ASCT) in resected breast cancer patients with 10 or more positive lymph nodes. MATERIALS AND METHODS: Between December 1994 and April 2000, 22 patients were enrolled. All patients received 2 to 6 cycles of adjuvant chemotherapy after surgery for breast cancer. The HDC regimen consisted of cyclophosphamide 1, 500 mg/m2/day, thiotepa 125 mg/m2/day and carboplatin 200 mg/m2/day intravenous for 4 consecutive days. RESULTS: With a median follow-up of 58 months, 11 patients recurred and died. The median disease-free survival (DFS) and median overall survival (OS) were 49 and 69 months, respectively. The 5-year DFS and OS rates were 50% and 58%, respectively. The 12 patients with 10 to 18 involved nodes had better 5-year DFS (67%) and OS (75%) than 10 patients with more than 18 involved nodes (30% and 38%, respectively). The most common grade 3 or 4 nonhematologic toxicity was diarrhea, which occurred in 5 patients (23%). No treatment-related death was observed. CONCLUSION: Consolidation HDC with CTCb followed by ASCT for resected breast cancer with more than 10 positive nodes had an acceptable toxicity but does not show promising survival.

Keyword

Breast Neoplasms; Peripheral blood stem cell transplantation; Cyclophosphamide; Thiotepa; Carboplatin; Consolidation

MeSH Terms

Breast Neoplasms*
Breast*
Carboplatin*
Chemotherapy, Adjuvant
Cyclophosphamide*
Diarrhea
Disease-Free Survival
Drug Therapy*
Follow-Up Studies*
Humans
Lymph Nodes*
Peripheral Blood Stem Cell Transplantation
Thiotepa*
Carboplatin
Cyclophosphamide
Thiotepa

Figure

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  Fig. 1 (A) Disease-free survival and (B) overall survival (median, 49 and 69 months, respectively).

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  Fig. 2 (A) Disease-free survival (DFS) and (B) overall survival (OS) according to the number of positive lymph nodes (DFS, p=0.036; OS, p=0.077).

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