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Neoadjuvant chemotherapy with infusional 5-fluorouracil, adriamycin and cyclophosphamide (iFAC) in locally advanced breast cancer: an early response predicts good prognosis

 Y. W. Moon  ;  S. Y. Rha  ;  H. C. Chung  ;  C. O. Suh  ;  W. I. Yang  ;  H. C. Jeung 
 ANNALS OF ONCOLOGY, Vol.16(11) : 1778-1785, 2005 
Journal Title
Issue Date
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Breast Neoplasms/drug therapy* ; Breast Neoplasms/pathology ; Breast Neoplasms/radiotherapy ; Breast Neoplasms/surgery ; Carcinoma, Ductal, Breast/drug therapy ; Carcinoma, Ductal, Breast/radiotherapy ; Carcinoma, Ductal, Breast/secondary ; Carcinoma, Ductal, Breast/surgery ; Carcinoma, Lobular/drug therapy ; Carcinoma, Lobular/radiotherapy ; Carcinoma, Lobular/secondary ; Carcinoma, Lobular/surgery ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Cyclophosphamide/administration & dosage ; Dose-Response Relationship, Drug ; Doxorubicin/administration & dosage ; Female ; Fluorouracil/administration & dosage ; Humans ; Infusions, Intravenous ; Maximum Tolerated Dose ; Middle Aged ; Neoadjuvant Therapy* ; Neoplasm Staging ; Prognosis ; Radiotherapy Dosage ; Survival Rate
adriamycin ; cyclophosphamide ; infusional 5-fluorouracil ; locally advanced breast cancer ; neoadjuvant chemotherapy
BACKGROUND: The aim of this study was to evaluate the efficacy and safety of neoadjuvant chemotherapy with infusional 5-fluorouracil (5-FU), adriamycin and cyclophosphamide (iFAC) in locally advanced breast cancer (LABC). PATIENTS AND METHODS: Eighty-two LABC patients were treated with neoadjuvant iFAC chemotherapy including infusional 5-FU (1000 mg/m2, continuous intravenous infusion, days 1-3), adriamycin (40 mg/m2, intravenous bolus, day 1) and cyclophosphamide (600 mg/m2, intravenous bolus, day 1) every 3 weeks until maximum tumor response. Patients subsequently received surgery, adjuvant chemotherapy, radiotherapy and hormonal therapy as appropriate. RESULTS: Downstaging occurred in 71 of the 82 patients (86.6%). Seventy-two patients (67 patients with downstaging and five patients without downstaging) were resectable (resectability rate, 87.8%). The clinical response rate was 84.2%, with a complete response (CR) rate of 17.1% and a pathological CR rate of 7.8%. During 891 cycles of chemotherapy, the most common grade 3/4 hematological toxicity was leukopenia (36.0%). There were no treatment-related deaths. The median follow-up period was 51 months, with a median overall survival (OS) of 66 months, and a 5 year OS rate of 50.9% for all patients. The 5 year OS and disease-free survival (DFS) rates of the 64 patients who underwent surgery were 55.8% and 44.7%, respectively. CONCLUSIONS: Neoadjuvant chemotherapy with iFAC had a comparable response rate and DFS to the conventional bolus FAC regimen, with an acceptable toxicity in LABC using the AJCC 2002 staging system. An early response to neoadjuvant iFAC was a favorable prognostic factor.
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1. College of Medicine (의과대학) > Research Institute (부설연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Moon, Yong Wha(문용화)
Suh, Chang Ok(서창옥)
Yang, Woo Ick(양우익) ORCID logo https://orcid.org/0000-0002-6084-5019
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Jeung, Hei Cheul(정희철) ORCID logo https://orcid.org/0000-0003-0952-3679
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