Journal of Clinical Oncology, Vol 8, 2032-2039, Copyright © 1990 by American Society of Clinical Oncology
Adjuvant cyclophosphamide, methotrexate, and fluorouracil in patients with axillary node-positive breast cancer: an update of the Guy's/Manchester trial
MA Richards, SM O'Reilly, A Howell, WD George, IS Fentiman, MA Chaudary, D Crowther and RD Rubens
International Cancer Research Fund Clinical Oncology Unit, Guy's Hospital, London, England.
Between 1976 and 1985, 391 patients (202 premenopausal, 189 postmenopausal)
with operable breast cancer and positive axillary lymph nodes were
randomized after total mastectomy and axillary clearance to receive
cyclophosphamide, methotrexate, and fluorouracil (CMF) (n = 193) or no
adjuvant therapy (n = 198). After a median follow-up of 8 years, both
relapse-free survival (RFS) and survival (S) were significantly prolonged
in premenopausal patients receiving CMF (RFS, P less than .001; S, P =
.003). Treatment with CMF resulted in a significant improvement in RFS in
premenopausal patients both with steroid receptor-positive and steroid
receptor-negative tumors and also in subgroups of premenopausal patients
defined by the number of axillary nodes involved. Premenopausal patients
who developed permanent amenorrhea following CMF had a significantly better
RFS than those who continued to menstruate. Induction of amenorrhea
following CMF was related to age, with almost all patients over 40 years
becoming amenorrheic. For patients less than or equal to 40 years,
development of amenorrhea following CMF did not influence outcome. No
difference was detected between control and CMF groups (RFS, P = .9; S, P =
.9) in postmenopausal patients nor in any subgroup of these patients. The
results of this trial of the efficacy of CMF for improving RFS and S have
strengthened with longer follow-up.
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Facebook  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
J. M. Walshe, N. Denduluri, and S. M. Swain
Amenorrhea in Premenopausal Women After Adjuvant Chemotherapy for Breast Cancer
J. Clin. Oncol.,
December 20, 2006;
24(36):
5769 - 5779.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Vehmanen, I. Elomaa, C. Blomqvist, and T. Saarto
Tamoxifen Treatment After Adjuvant Chemotherapy Has Opposite Effects on Bone Mineral Density in Premenopausal Patients Depending on Menstrual Status
J. Clin. Oncol.,
February 1, 2006;
24(4):
675 - 680.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. R. Parulekar, A. G. Day, J. A. Ottaway, L. E. Shepherd, M. E. Trudeau, V. Bramwell, M. Levine, and K. I. Pritchard
Incidence and Prognostic Impact of Amenorrhea During Adjuvant Therapy in High-Risk Premenopausal Breast Cancer: Analysis of a National Cancer Institute of Canada Clinical Trials Group Study--NCIC CTG MA.5
J. Clin. Oncol.,
September 1, 2005;
23(25):
6002 - 6008.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Vanhuyse, C. Fournier, and J. Bonneterre
Chemotherapy-induced amenorrhea: influence on disease-free survival and overall survival in receptor-positive premenopausal early breast cancer patients
Ann. Onc.,
August 1, 2005;
16(8):
1283 - 1288.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. J. Pierce
The Use of Radiotherapy After Mastectomy: A Review of the Literature
J. Clin. Oncol.,
March 10, 2005;
23(8):
1706 - 1717.
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Shikama, S. Sasaki, M. Mitsumori, M. Hiraoka, C. Yamauchi, T. Yamamoto, T. Teshima, and T. Inoue
Patterns of Care Study in Japan: Analysis of Patients Subjected to Mastectomy Followed by Radiotherapy
Jpn. J. Clin. Oncol.,
September 1, 2003;
33(9):
456 - 462.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. C. Dale, G. C. McCarter, J. Crawford, and G. H. Lyman
Myelotoxicity and Dose Intensity of Chemotherapy: Reporting Practices From Randomized Clinical Trials
J Natl Compr Canc Netw,
July 1, 2003;
1(3):
440 - 454.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. I. Pritchard
Adjuvant Therapy for Premenopausal Women With Breast Cancer: Is It Time for Another Paradigm Shift?
J. Clin. Oncol.,
December 15, 2002;
20(24):
4611 - 4614.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. J. Pierce
Treatment Guidelines and Techniques in Delivery of Postmastectomy Radiotherapy in Management of Operable Breast Cancer
J Natl Cancer Inst Monographs,
December 1, 2001;
2001(30):
117 - 124.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Yamauchi, V. Stearns, and D. F. Hayes
When Is a Tumor Marker Ready for Prime Time? A Case Study of c-erbB-2 as a Predictive Factor in Breast Cancer
J. Clin. Oncol.,
April 15, 2001;
19(8):
2334 - 2356.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M.A. Richards
Systemic Treatment of Breast Cancer
Perspectives in Public Health,
August 1, 1991;
111(4):
141 - 145.
|
|
|
|
