CAF vs. CMF Combination Chemotherapy in Advanced Breast Cancer Patients

Breast cancer is the second most common neoplasm in women. There has been a modest increase in the duration of survival of most women with breast cancer. This increase in survival has come about because of the recognition that breast cancer is a systemic disease. Systemic nature is the driving force behind newer chemotherapeutic approaches. The purpose of this study was to determine the relative efficacy and toxicity of Doxorubicin (Adriamycin) versus Methotrexate in combination with intravenous Cyclophosphamide and 5-Fluorouracil as a palliative therapy in locally advanced, locoregionally recurrent and distant metastatic breast cancer patients. The study was carried out in a tertiary care centre, for a period of 20 months. Histopathologically confirmed breast cancer patients (female) with ductal carcinoma or lobular carcinoma who had locoregionally advanced disease were enrolled in the study. Twenty eight patients received CAFregimen and twenty patients received CMF regimen with prophylactic antiemetics after baseline biochemical and metastasis evaluation. Acute toxicity was evaluated for 24 hours on the day of chemotherapy and followed up for the side effects. Patients were planned for treatment with minimum of 4 cycles of chemotherapy. The response was quantified as complete response, partial response and no response. Complete responders were given 2 more cycles and treatment was stopped. Non responders were withdrawn from the study. Partial responders were planned for 2 more cycles and reassessed and chemotherapy was continued till progressive disease was seen or upto a maximum of 9 cycles whichever occurred earlier. Results were analysed by Students t test. Complete response rate in CAF arm was 39 % (11/28) & in CMF arm was 15 % (3/20). Overall response (complete+ partial) rate in CAF arm was 64 % (18/28) & in CMF arm was 55 % (11/20). Both CAF and CMF regimen were active, safe & convenient.