J Korean Cancer Assoc.
2000 Dec;32(6):1059-1066.
High Dose Chemotherapy with Ifosfamide, Carboplatin, and Etoposide Followed by Autologous Stem Cell Transplantation in Breast Cancer
- Affiliations
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- 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. seonpark@plaza.snu.ac.kr
- 2Department of Internal Medicine, Gachon Medical SchoolSeoul, Korea.
- 3Department of Internal Medicine, Hallym University School of Medicine, Seoul, Korea.
Abstract
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PURPOSE: To establish the feasibility of high dose ifosfamide, carboplatin, and etoposide (ICE) chemotherapy followed by autologous stem cell transplantation (ASCT) in patients with high-risk or metastatic breast cancer.
MATERIALS AND METHODS
High-risk breast cancer is defined as 10 or more involved axillary lymph nodes (n=3) or stage III (n=2). Patients with metastatic cancer have relapsed diseases after curative resection (n=10) or initially metastatic lesion (n=1). Colony stimulating factor with either cyclophosphamide or combination chemotherapy was administered to mobilize the stem cells. High dose chemotherapy consisted of ifosfamide 16 g/m2, carboplatin 1.8 g/m2, and etoposide 0.75 g/m2 (dose I) and later modified to ifosfamide 12 g/m2, carboplatin 1.35 g/m2, and etoposide 1.2 g/m2 (dose II).
RESULTS
The median duration of grunulocyte nadir (<500/ microliter) was 11 (10~17) days and platelet transfusion dependency (<20,000/ microliter) was 11 (7~53) days in 14 patients who achieved engraftment. One out of 5 patients with high-risk breast cancer relapsed after high dose therapy. Two patients remain disease-free at 18th and 40th months. Two among the 4 patients treated with dose I died due to treatment-related complications. The responses of metastatic diseases to ICE chemotherapy were 1 continuing CR, 1 CR, 1 PR, 4 SD and 3 PD in 10 evaluable patients.
CONCLUSION
High dose ICE chemotherapy, especially dose II and ASCT were feasible in high-risk or metastatic breast cancer.
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