R. Vij et al., Outcomes of high-dose chemotherapy and autologous stem cell transplant in isolated locally recurrent breast cancer: a multicenter evaluation, BONE MAR TR, 26(9), 2000, pp. 947-953
Citations number
42
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology,"Medical Research Diagnosis & Treatment
To determine the outcomes of women with isolated locoregional recurrence (L
RR) of breast cancer treated with high-dose chemotherapy (HDCT) and autolog
ous stem cell transplantation (ASCT) following conventional therapy, we con
ducted a retrospective review of 58 patients from five institutions treated
between 1990 and 1998, Forty-five patients (78%) had greater than or equal
to2 poor prognostic factors (PPF) (defined as disease-free interval preced
ing LRR less than or equal to2 years, hormone receptor negative/refractory
disease, and incomplete resection), At median follow-up of 14.2 (0.5-72) mo
nths, 36 patients (62%) developed progressive disease. Disease progression
usually occurred at local (27 patients) Its distant (nine patients) sites.
Median time to disease progression following ASCT was 6.1 (1.3-31.4) months
. At last follow-up, 23 patients (40%) had expired tall due to disease prog
ression), and 13 (22%) were alive with, and 22 (38%) without progressive di
sease. By Kaplan-Meier analysis, the estimated median PFS and OS was 20.3 a
nd 29.2 months, respectively. In a multivariate model, complete remission a
t time of HDCT and estrogen-receptor positive disease were predictive of si
gnificantly longer PFS and OS, The survival of this cohort was similar to p
revious reports of those treated with conventional therapy alone, and to th
ose with distant metastases treated with HDCT. Frequent progression locally
, suggests that strategies to improve local disease control are needed.