Combination Chemotherapy in Treating Women With Stage III Breast Cancer
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells.
PURPOSE: Randomized phase III trial to compare cyclophosphamide, doxorubicin, and fluorouracil with cyclophosphamide, methotrexate, and fluorouracil in treating women with stage III breast cancer.
Drug: CAF regimen
Drug: CMF regimen
Drug: doxorubicin hydrochloride
Procedure: adjuvant therapy
Procedure: conventional surgery
Procedure: neoadjuvant therapy
Radiation: radiation therapy
|Study Design:||Allocation: Randomized
Primary Purpose: Treatment
|Official Title:||MULTIMODALITY TREATMENT STRATEGY FOR STAGE III BREAST CANCER|
|Study Start Date:||October 1995|
- Compare the response in women with stage III breast cancer treated with neoadjuvant fluorouracil, doxorubicin, and cyclophosphamide (FAC) vs cyclophosphamide, methotrexate, and fluorouracil (CMF).
- Compare the rates of conservative surgical resectability and locoregional control in patients treated with these neoadjuvant therapy regimens.
- Compare the disease-free and overall survival of patients treated with these regimens.
- Compare the toxic effects of these regimens in these patients.
- Compare the compliance of patients treated with these regimens.
- Assess the cosmetic results in patients treated with conservative surgery.
- Compare the quality of life of patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to participating center.
- Arm I: Patients receive fluorouracil (5-FU) IV on days 1 and 8 and doxorubicin IV and cyclophosphamide (CTX) IV on day 1 (FAC). Treatment continues every 3 weeks for 3 courses in the absence of disease progression.
- Arm II: Patients receive CTX IV, methotrexate IV, and 5-FU IV on days 1 and 8 (CMF). Treatment continues every 4 weeks for 3 courses in the absence of disease progression.
Patients on both arms with resectable disease after the third course of chemotherapy undergo quadrantectomy with axillary node dissection (preferred) or modified radical mastectomy, followed by 6 additional courses of chemotherapy on the arm to which they were randomized initially. Those patients without distant metastasis undergo locoregional radiotherapy beginning concurrently with the initiation of postoperative chemotherapy. Patients on both arms with unresectable disease after the initial 3 courses of chemotherapy undergo locoregional radiotherapy and then surgical resection (if feasible).
Quality of life is assessed at baseline and then monthly thereafter.
Patients are followed every 3-4 months for 2 years, every 4-6 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: Not specified
|Policlinica Privada Instituto De Medicina Nuclear|
|Bahia Blanca, Buenos Aires, Argentina, 8000|
|Consultorio Oncologico Privado|
|Mar del Plata, Buenos Aires, Argentina, 7600|
|Centro De Oncologia y Terapia Radiante|
|Santa Rosa, La Pampa, Argentina, 6300|
|Unidad Oncologica Del Comahue|
|Consultorio Oncologico Privado|
|Rio Gallegos, Argentina, 9400|
|Centro Oncologico Del Litoral|
|Santa Fe, Argentina, 3000|
|Centro Oncologico Tres Arroyos|
|Tres Arroyos, Argentina, 7500|
|Study Chair:||Bernardo A. Leone, MD||Unidad Oncologica Del Neuquen|