Neoadjuvant chemotherapy in locally advanced breast cancer:: a preliminary report

A pilot study of neoadjuvant chemotherapy with cyclophosphamide / epirubicin / 5-fluorouracyl (FEC) was performed on 85 patients with locally advanced breast cancer. Patients received four cycles of neoadjuvant chemotherapy followed by surgery, radiotherapy and treatment with cyclophosphamide / methotrexate /5-fluorouracyl for three cycles. Major clinical response was obtained in 76 (89%) patients. Complete response was documented in 14 (17%) patients at pathologic examination of surgical specimen. Grade (G)1-2 nausea and vomiting was the most. ONCOLOGY common (77%) side effect. G 2-3 alopecia was 66%. G 2-3 neutropenia occurred in 16% of patients. None of the patients have developed febrile neutropenia. Sinusal tachicardia was observed only in one patient. Three patients had a more than 10 % decrease in the left ventricular ejection fraction without any clinical signs. As nine patients had progressive or stable disease, four were not subjected to surgical and/or radiation therapy, they were excluded from survival analysis. After a median follow-up of 31 months (range:15-41), disease free survival (DFS) and overall survival (OS) were 20 (r:13-32) and 23 months (r:17-32). In conclusion, FEC combination is safe and effective for neoadjuvant setting in locally advanced breast cancer. Further follow-up is necessary for the endpoint results.