Alternância intensiva de drogas sem resistência cruzada presumível com methotrexate, adriamicina, ciclofosfamida, vincristina e fluorouracil (MACOM-F) no câncer da mama avançado locorregional
DOI:
https://doi.org/10.32635/2176-9745.RBC.1992v38n2/3.3081Keywords:
Advanced Breast Cancer, ChemotherapyAbstract
A new treatment strategy for locally advanced breast cancer was developed with alternanting non-cross-resistante chemotherapy without cumulativo toxicity, for 12 weeks. This approach intended to obtain fast tumor destruction and micrometastasis treatment. In this fase II study, 24 patients were included and evaluable with good performance status (PS 0 and 1). AH patients received combination chemotherapy with cyclophosphamide 300 mg/nf and adriamycin 50 mg/rrP In weeks 1, 3, 5, 7, 9 and 11; methotrexate 100 mg/nf in weeks 2, 4, 6,8, 10 and 12; 5-fluorouracil 600 mg/nf in weeks 4, 8 and 12 (MACOM-F). A clinical complete remission was achieved in nine (37%) patients, 13 (54%) achieved a partial remission and two (9%) stable disease. Toxicity was frequent but without deaths. Seventeen patients were submitted to radical mastectomy and one to tumorectomy plus axiliary dissection. The principal aims of this protocol was: 1) to test the Goldie and Colman foundations in the stage III prímary breast câncer treatment; 2) to study the alternating more effective drug combination in breast cancer and 3) to verify the impact of this strategy in disease-free survival and overal survival. Computer analysis was performed for: a) correlate tumor reduction with ieukopenia in 208 chemotherapy cycies; b) correlate superfícies with volume tumor and c) to plot the rhythm of tumor destruction to know the shortest time to mastectomy. The conclusions of this method: 1) There is good correlation between tumor were destruction and Ieukopenia induced by chemotherapy; 2) leukocyte reduction is a mark of tumor destruction and 3) surgery would be performed after 6 cycies of chemotherapy. At 53 months of follow-up 44% of patients are free of disease and 59% alive, wich seems a improvement in stage III disease. The MACOM-F was a new effective neoadjuvant treatment schedule to stage III breast câncer but funher analysis is recommended.
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