Archive of Oncology (Jan 2003)

Clinical efficacy of neoadjuvant FAC chemotherapy in locally advanced breast cancer patients

  • Ždrale Zdravko,
  • Šušnjar Snežana,
  • Stamatović Ljiljana,
  • Matijašević Miodrag,
  • Nešković-Konstantinović Zora

DOI
https://doi.org/10.2298/AOO0303148Z
Journal volume & issue
Vol. 11, no. 3
pp. 148 – 148

Abstract

Read online

Background: FAC chemotherapy (CT) regimen is a well-established standard in the neo-adjuvant or primary chemotherapy for locally advanced breast cancer (LABC) treatment. Its main goal is to achieve locoregional tumor shrinkage allowing for the radical surgical treatment with curative intent. Concerning that prognosis of these patients depends on the response to initial neo-adjuvant therapy, we have analyzed clinical response to standard FAC CT in a group of routinely treated unrespectable LABC patients. Methods: During the three-year period, 50 pre- and postmenopausal patients without any cardiac risk factors, aged from 38-61 years, were treated with 3 to 4 cycles of neo-adjuvant FAC CT (500-50-500 mg/m 2 /21d). The initial diagnosis of LABC was based on tumor, nodal and/or skin characteristics: in 25 patients tumor was classified as T3-T4, N2 category was registered in 28 patients while skin lymphagiosis was found in 22 patients. Pathological diagnosis was confirmed either by skin, tumor and/or lymph node biopsy, or by tumorectomy (in 45 and 5 patients, respectively). Steroid receptor status was determined by biochemical DCC method in 35, or by immunohistochemistry in 7 patients. Results: Axillary lymph node status was evaluable in 47/50, and T status in 48/50 patients. Objective nodal response was achieved in 41/47 patients (12 CR and 29 PR, respectively), inflammatory skin features responded in 17/22 patients (2CR and 15PR, respectively). Overall objective response was achieved in 41/48 (82%) patients (9 CR, 32 PR), while 5 patients were classified as SD, and 2 consecutive patients as PD, with 2 non-evaluable patients. As far as toxicity was concerned, no acute cardiac damage was noted, emesis was successfully prevented with standard anti-emetics, and grade 3 to 4 alopecia developed in most of patients. Hematological tolerance was also good. Conclusion: Our results confirmed the high response rate to standard neoadjuvant FAC CT in unresectable LABC patients, in whom downstaging was achieved in majority, allowing for radical surgical treatment.

Keywords