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334 Chapter 6: Breast Cancer
CD
O
1.0
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
n= 13
Stage IV Breast Cancer
CAT A Survival
Alive = 12
Med FU = 38 months
20 40
Months From HD To FU
60
Median
Figure 2. Survival of category A metastatic breast cancer. On the horizontal axis, the time
from onset of high dose (HD) to last follow-up (FU) has been plotted. N, number; Med FU,
median follow-up of all patients.
Responses were measured by progression-free survival estimates. Also, overall
survival was determined as response to treatment since progression of disease was
determined as early as possible by using the cytokeratin assay measuring small
numbers of breast cancer cells in the marrow and peripheral blood 5
as well as by
change in tumor markers in the serum without radiographic changes.
RESULTS
Patients were divided into three groups: category A (13 patients), no evidence of
disease at time of starting intensive chemotherapy; category B (31 patients), were
patients who responded to normal dose but demonstrated evidence of disease at time
of intensive chemotherapy, i.e., chemotherapy-sensitive; category C were patients
with progression of disease after normal-dose chemotherapy, i.e., chemotherapyresistant.
The best results were obtained in category A patients: median progressionfree
survival (PFS) of 32 months, and a 90% projected survival of 5 years as
documented in Figs. 1 and 2, respectively. The median PFS and overall survival of
category B patients were 23 and 36 months, respectively, as documented in Figs. 3
and 4. The median survival of category C patients was 13 months (Fig. 5).