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Too much chemotherapy in metastatic breast cancer (MBC)?
178s
D-III
O~T~~~Z~~ OR ~OSTO~~RATX~ ~OCRI~~ TR~AT~T WITH T~O~E~~~T~DX~E~) XE SW&I; FY GLAND CAIGRR R? PATXERTS OVER 60 YEARS. Poateuc& M., PostffuaB R. -DfstriGt Wospital - SuceavaRomania The auih& carried out a prospective preoperative and postoperative clinical trial. comparing the efficacy of the antioeetrogenic hormonal therapy with TMN, with the same method applied only preoperatively. The study includes 41 patients within 60-81 years with atage IIIamammary cancer with clinical classifications T3a No l?NlaNib. The patients were operated with radical mastectomy of Halsted type and did not present metastasas in the axillezy gangliona taken out. The preoperative irradiation has been made simultaneously with antfoestrogenic hormonal therapy with TIE?-30 mg dally preoperatfvely and 20 mg dally postoperatively without daily or total dose individualizationa in connection with the hlatopathofogical formfall the casea were invasive epitheIiaZ tuaours~ or their grading. TMR was preoperatively adm~nistred for about 3 months and poatoperat~ve~y for 18 months with a follow-up intesval and have been followed up for periodical re-evaluat ion of 38 months. The patients 4 yeara. It has been ascertained a deeease-free interval of 58 I in the group of patients treated only preoperatively and of 72 % in those treated both preoperatively. The survival at 4 yeara was of 58 “;s for the first group and of 47 % for the second one (control group) with a medlan interval of local seconda evolution of 22,5 monthe(studied regional recurrence or of distant of group) and of 17,7 months( control group). ?; t appears that a prolongation adjuvant therapy with TMN over 18-24 months would be ealutary in postoperative treatment, of the patients over 60 years with mammary cancer. D-112 CALCITONIN RELATED PEPTIDES IN ACUTE LEUKEMIA. Pfliiger K-H., Kiippler H. and Havemann K. of Marbury, Department of Internal Medicine, Philipps-University Oncology, 3550 Marburg, Baldingerstrasse, West-Germany
Division
of Hematology
and
Numerous malignant tumors are capable to synthesize and secrete peptide hormones not evaluates the incidence and normally produced by the tissue of origin. This investigation clinical impact of calcitonin related peptides in patients with acute leukemia. Seventy-seven patients were included in the study. Human calcitonin (h-CT), calcitonin gene related peptide (CGRP), and salmon calcitonin (s-CT) were found to be elevated in serum Increased concentration of at least one 0.f these three in 46.7%, 51% and 20.7% respectively. peptides was found in 77%. More immature forms of acute leukemia such as ~1 and AUL showed a significant higher incidence as compared to the other subtypes. The production of these hormones was also seen in established leukemic cell lines and in buffy coat cells. Using multivariate analysis only age and elevated serum level of h-CT were found to be correlated hormone production may influence the to prognosis. The possibility that paraneoplastic biological behaviour of the leukemic blasts will be discussed.
D-113 TOO MUCH CHEMOTI-ERAF'Y IN METASTATIC BREAST CANCER (WC)? Porzsolt3 F., Bucheltl L., Neuret2 G., Mende2 S., Kreuser3 E.D., Schreml 3 W. Regional Study Group - Oncology Centers G&pincenl, Ravensbuxm*. Univ. Ulm3. FRG The original aim- of this phase IV study was to demonstrke that a co&x protocol for treatment of MC can be realized in a CKOUD of 27 mainlv non-universitv hosoitals. Corrnarim the survival data of pts without and iith'violations of the treatment*prot&ol, we ob&rvez differences which suggest that too many pts with MDC are treated by aggressive chemotherapy regimens. 335 evaluable pts were prospectively included in the study between Jan. 83 and Dec.
85. 38% of pts were stratified to a high risk group defined by at least 1 out of 7 criteria. The different survival of low (L) and high 0-l) risk pts (p ( O.ODOl) confirms a fairly gooo As first line therapy (tx), H-pts received combined chemosegregation by these criteria. therapy (C) 5 hormonal tx (H); L-pts were treated with TAMor ovarectomy. A complex protocol described up to 8 consecutive lines of tx for each subgroup of pts in case of progressive disease. Three types of protocol violations (pv) were recorded: “more aggressive”, “less aggressive”, %imilarW. 51 pts did not receive the poposed Ii; 4% of these pts received a more aggressive tx, 3K a less aggressive, and 2& a similar tx. Deviations from 118 proposed CZH were less aggressive tx in 4% and similar tx in 5%. 2 yr survival of L-pts was shorter (p=O.O015) in those with deviations from protocol (466) conpared to those without pv (71316).In contrast, ltpts who were not treated according to protocol survived longer (4ClK) than those without pv (la) (p=O.O070>. Since the majority of H-pts with pv received less aggressive tx and the majority of L-pts with pv received mOre aggressive tx it is suggested that at least some pts of both, H and L groups, might not benefit Pramaggressive C.
D-III
O~T~~~Z~~ OR ~OSTO~~RATX~ ~OCRI~~ TR~AT~T WITH T~O~E~~~T~DX~E~) XE SW&I; FY GLAND CAIGRR R? PATXERTS OVER 60 YEARS. Poateuc& M., PostffuaB R. -DfstriGt Wospital - SuceavaRomania The auih& carried out a prospective preoperative and postoperative clinical trial. comparing the efficacy of the antioeetrogenic hormonal therapy with TMN, with the same method applied only preoperatively. The study includes 41 patients within 60-81 years with atage IIIamammary cancer with clinical classifications T3a No l?NlaNib. The patients were operated with radical mastectomy of Halsted type and did not present metastasas in the axillezy gangliona taken out. The preoperative irradiation has been made simultaneously with antfoestrogenic hormonal therapy with TIE?-30 mg dally preoperatfvely and 20 mg dally postoperatively without daily or total dose individualizationa in connection with the hlatopathofogical formfall the casea were invasive epitheIiaZ tuaours~ or their grading. TMR was preoperatively adm~nistred for about 3 months and poatoperat~ve~y for 18 months with a follow-up intesval and have been followed up for periodical re-evaluat ion of 38 months. The patients 4 yeara. It has been ascertained a deeease-free interval of 58 I in the group of patients treated only preoperatively and of 72 % in those treated both preoperatively. The survival at 4 yeara was of 58 “;s for the first group and of 47 % for the second one (control group) with a medlan interval of local seconda evolution of 22,5 monthe(studied regional recurrence or of distant of group) and of 17,7 months( control group). ?; t appears that a prolongation adjuvant therapy with TMN over 18-24 months would be ealutary in postoperative treatment, of the patients over 60 years with mammary cancer. D-112 CALCITONIN RELATED PEPTIDES IN ACUTE LEUKEMIA. Pfliiger K-H., Kiippler H. and Havemann K. of Marbury, Department of Internal Medicine, Philipps-University Oncology, 3550 Marburg, Baldingerstrasse, West-Germany
Division
of Hematology
and
Numerous malignant tumors are capable to synthesize and secrete peptide hormones not evaluates the incidence and normally produced by the tissue of origin. This investigation clinical impact of calcitonin related peptides in patients with acute leukemia. Seventy-seven patients were included in the study. Human calcitonin (h-CT), calcitonin gene related peptide (CGRP), and salmon calcitonin (s-CT) were found to be elevated in serum Increased concentration of at least one 0.f these three in 46.7%, 51% and 20.7% respectively. peptides was found in 77%. More immature forms of acute leukemia such as ~1 and AUL showed a significant higher incidence as compared to the other subtypes. The production of these hormones was also seen in established leukemic cell lines and in buffy coat cells. Using multivariate analysis only age and elevated serum level of h-CT were found to be correlated hormone production may influence the to prognosis. The possibility that paraneoplastic biological behaviour of the leukemic blasts will be discussed.
D-113 TOO MUCH CHEMOTI-ERAF'Y IN METASTATIC BREAST CANCER (WC)? Porzsolt3 F., Bucheltl L., Neuret2 G., Mende2 S., Kreuser3 E.D., Schreml 3 W. Regional Study Group - Oncology Centers G&pincenl, Ravensbuxm*. Univ. Ulm3. FRG The original aim- of this phase IV study was to demonstrke that a co&x protocol for treatment of MC can be realized in a CKOUD of 27 mainlv non-universitv hosoitals. Corrnarim the survival data of pts without and iith'violations of the treatment*prot&ol, we ob&rvez differences which suggest that too many pts with MDC are treated by aggressive chemotherapy regimens. 335 evaluable pts were prospectively included in the study between Jan. 83 and Dec.
85. 38% of pts were stratified to a high risk group defined by at least 1 out of 7 criteria. The different survival of low (L) and high 0-l) risk pts (p ( O.ODOl) confirms a fairly gooo As first line therapy (tx), H-pts received combined chemosegregation by these criteria. therapy (C) 5 hormonal tx (H); L-pts were treated with TAMor ovarectomy. A complex protocol described up to 8 consecutive lines of tx for each subgroup of pts in case of progressive disease. Three types of protocol violations (pv) were recorded: “more aggressive”, “less aggressive”, %imilarW. 51 pts did not receive the poposed Ii; 4% of these pts received a more aggressive tx, 3K a less aggressive, and 2& a similar tx. Deviations from 118 proposed CZH were less aggressive tx in 4% and similar tx in 5%. 2 yr survival of L-pts was shorter (p=O.O015) in those with deviations from protocol (466) conpared to those without pv (71316).In contrast, ltpts who were not treated according to protocol survived longer (4ClK) than those without pv (la) (p=O.O070>. Since the majority of H-pts with pv received less aggressive tx and the majority of L-pts with pv received mOre aggressive tx it is suggested that at least some pts of both, H and L groups, might not benefit Pramaggressive C.