[Chemotherapy of metastasizing breast cancer. Adriamycin mono and combination therapy after LMFP pretreatment].

To test the effectiveness of adriamycin (ADM: doxorubicin), alone or in combination with other cytostatic drugs, as second treatment, the course of illness in 53 patients with metastasizing carcinoma of the breast was analysed retrospectively. After pre-treatment with leukeran (chlorambucil), methotrexate, fluorouracil and prednisone (LMFP), they were treated with ADM, either alone or in combination with other drugs. Twenty-seven patients were pre-treated with hormones. If progression was demonstrated under LMFP, treatment was continued either with ADM alone; with ADM, vincristin and cyclophosphamide (VAC); or with other ADM combinations. On LMFP 25 patients (47%) had remission of a mean duration of 10.5 months and mean survival time of 23 months. With ADM alone during the second treatment phase there was no case of remission, while with VAC remission was obtained in 38%, with other ADM combinations in 39%. The median second-remission duration was seven months with VAC and five with other ADM combinations, median survival time 11 months with VAC and nine months with other ADM combinations. 25% of patients had a survival rate of twenty-four months after onset of second treatment with VAC. The most important side-effect during the ADM treatment phase was total alopecia (92% of patients). Haematological and gastrointestinal side-effects were also more marked than during the first treatment phase (with LMFP).