The DOI matches its Crossref record; 11 of the 11 references it cites were found in a registry or an index.
High-Dose Chemotherapy with Hematopoietic Stem-Cell Rescue for High-Risk Breast Cancer
Open accessAbstract
BACKGROUND: The use of high-dose adjuvant chemotherapy for high-risk primary breast cancer is controversial. We studied its efficacy in patients with 4 to 9 or 10 or more tumor-positive axillary lymph nodes. METHODS: Patients younger than 56 years of age who had undergone surgery for breast cancer and who had no distant metastases were eligible if they had at least four tumor-positive axillary lymph nodes. Patients in the conventional-dose group received fluorouracil, epirubicin, and cyclophosphamide (FEC) every three weeks for five courses, followed by radiotherapy and tamoxifen. The high-dose treatment was identical, except that high-dose chemotherapy (6 g of cyclophosphamide per square meter of body-surface area, 480 mg of thiotepa per square meter, and 1600 mg of carboplatin per square meter) with autologous peripheral-blood hematopoietic progenitor-cell transplantation replaced the fifth course of FEC. RESULTS: Of the 885 patients, 442 were assigned to the high-dose group and 443 to the conventional-dose group. After a median follow-up of 57 months, the actuarial 5-year relapse-free survival rates were 59 percent in the conventional-dose group and 65 percent in the high-dose group (hazard ratio for relapse in the high-dose group, 0.83; 95 percent confidence interval, 0.66 to 1.03; P=0.09). In the group with 10 or more positive nodes, the relapse-free survival rates were 51 percent in the conventional-dose group and 61 percent in the high-dose group (P=0.05 by the log-rank test; hazard ratio for relapse, 0.71; 95 percent confidence interval, 0.50 to 1.00). CONCLUSIONS: High-dose alkylating therapy improves relapse-free survival among patients with stage II or III breast cancer and 10 or more positive axillary lymph nodes. This benefit may be confined to patients with HER-2/neu-negative tumors.
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Metadata
- Authors
- Rodenhuis, S., Bontenbal, M., Beex, L. V. A. M., Wagstaff, J., Richel, D. J., Nooij, M. A., Voest, E. E., Hupperets, P., van Tinteren, H., Peterse, H. L., TenVergert, E. M., & de Vries, E. G. E.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2003-07-03
- Volume
- 349
- Issue
- 1
- Pages
- 7-16
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W1973560717
- Cited by
- 258
- References
- 11
- FWCI
- 13.99
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Rodenhuis, S., Bontenbal, M., Beex, L. V. A. M., Wagstaff, J., Richel, D. J., Nooij, M. A., Voest, E. E., Hupperets, P., van Tinteren, H., Peterse, H. L., TenVergert, E. M., & de Vries, E. G. E. (2003). High-Dose Chemotherapy with Hematopoietic Stem-Cell Rescue for High-Risk Breast Cancer. New England Journal of Medicine. https://doi.org/10.1056/nejmoa022794
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