74 Concomitant adjuvant chemotherapy (FNC regimen) and radiotherapy in operable stage II breast cancer (O.B.C.)

• Published in: European journal of cancer (1990) 1995-11, Vol.31, p.S17-S17
• Main Authors: Serin, D., Reboul, R., Vincent, P., Chauvet, B., Kirscher, S., Aimard, L., Plat, R., Brewer, Y., Felix-Faure, C.
• Format: Article
• Language: English
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/0959-8049(95)95326-2

The purpose of multimodality treatment including simultaneous radiochemotherapy is to reduce the total length of the adjuvant treatment after surgery. Aims of study were to evaluate the compliance, global toxicity and local cutaneous side effect. The treatment scheme is F.N.C (F: Flourouracil 500 mg/m 2, N: Mitoxantrone 12 mg/m 2, C: Cyclophosphamide: 500 mg/m 2) every 21 days. Six cycles for N+, 4 cycles for N− with poor prognosis (RH- or SBR III). Radiotherpy is indicated by the consensus of the “Societe Francaise de Radiotherapie Oncologique” S.F.R.O. (50 Gy/25 fractions/5 weeks, 15 Gy overdose when T > 10 mm). We report a feasibility study in 154 pts with O.B.C. included from May 90 to October 95 Median age: 49, 5 y (29–72), postmenopausal: 46.8%; premenopausal: 52.6%; Performance Status O: 96.7%, 1: 2%, unknown: 1.3%, Radical surgery: 29.9% conservative: 69.5%, N−: 29.9%; N+: 70.1%. Ductal carcinoma: 85.7%, lobular: 5.8%, SBR I: 2.6%, SBR II: 26.6%, SBR III: 65.6%. Total number of courses was 773 (60.4% of pts received 6 courses). Full dose of N was administered to 84.4% of pts, F to 90.3%, C to 88.3%. Interval between 2 cycles was 21 days in 30.9% pts, 28 days in 45.4% pts, upper than 28 days in 23.7% pts. Median total radiotherapy dose was 50 Gy. Main toxicities observed (per pts) were: gastrointestinal grade 3–4: 4.6%, dysphagia: 27.9%, leucopenia grade 3–4: 12.3%, anemia grade 2: 2%, thrombocytopenia grade 2: 1 pt. A reversible cardiotoxicity occurred in 15 pts including extrasystole: 1 pts, low blood pressure: 2 pts, pericarditis 3 pts. Local toxicity was mild (grade ≤ 1: 62.3%, grade 2: 16.9% and grade 3: 4.5%). No major pulmonary toxicity was observed. Quality of life (E.C.O.G scale) was performed to evaluate the repercussion of this treatment grade 0: 44.2%, grade 1: 34.4%, grade 2: 7.8% and grade 3 in 1 pt. Well acceptability of treatment in 51.9% of pts. Mitoxantrone containing chemotherapy and postoperative radiotherapy can thus be combined in an adjuvant treatment program with good compliance and acceptable toxicity. Ongoing or further study of a large patients groups comparing various strategies of chemotherapy and radiation sequencing will be needed to confirm our data.