Outcomes of high-dose chemotherapy and autologous stem cell transplant in isolated locally recurrent breast cancer: a multicenter evaluation

Citation
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
Journal title
BONE MARROW TRANSPLANTATION
ISSN journal
0268-3369 → ACNP
Volume
26
Issue
9
Year of publication
2000
Pages
947 - 953
Database
ISI
SICI code
0268-3369(200011)26:9<947:OOHCAA>2.0.ZU;2-5
Abstract
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.