COMBINATION OF CHEMOTHERAPY AND HORMONE-THERAPY IN ADVANCED BREAST-CANCER

In a prospective study at the Department of Obstetrics and Gynaecology, University of Erlangen, patients with advanced breast carcinoma were treated with a combination of chemotherapy and hormone therapy. Patients received one injection of Decapeptyl(R) in a 28 days interval. At day 12 and 13 of the treatment cycle 40 mug of ethinylestradiol were applicated followed by intravenous chemotherapy with 500 mg/m2 fluorouracil, 10 mg/m2 mitoxantrone and 500 mg/m2 cyclophosphamide took place on day 14. 39 patients were integrated in this study. All of these patients were evaluable regarding the side-effects and 36 patients concerning the response rate. In case of response after 6 cycles the interval between the chemotherapy was prolonged to 6 weeks and the Decapeptyl(R) injections remained in a 4 weeks interval. 15 patients received this combined therapy as a first-line therapy, 24 patients as a second-line therapy or third-line therapy. 2 patients had a complete remission, 14 patients had a partial remission. The objective response rate (CR+PR) was therefore 44 %. In 8 patients the response was classified as no change, consequently the total response rate (CR + PR + NC) was 67 %. 12 patients showed a progression (33 %), 2 patients with several previous treatments suffered an early progress. 3 patients did not finish the therapy. The median response duration was 9 months and the median follow up time until now is 13 months; 24 patients died. Therapy related side-effects were tolerable. As the most frequent side-effect bone marrow suppression were observed. Subjective, for the patients most inconvenient side-effects like nausea, vometing, and alopecia seldomly appeared. The combination of chemotherapy and hormone therapy achieved with a good toleration response rates, which are compatible to international standards of chemotherapy. The exspectations to achieve a better remission rate by a combination of chemotherapy and hormone therapy rather than chemotherapy alone were not fulfilled in this studie.