Background: Since 1999, patients presenting with brain metastases (BM) from breast cancer (BC) are treated in our institution with a carmustine (BCNU)--methotrexate (MTX) combination. We report here our clinical experience regarding this combination.
Patients And Methods: Patients were treated by a combination of BCNU 100 mg/m(2) on day 1 and MTX 600 mg/m(2) on day 1 and 15 of a 28 day cycle. Treatment was continued until progression or unacceptable toxicity.
Results: 50 patients were treated between 1999 and 2007. 94% of the patients presented with concomitant extra-cerebral disease. Median number of previous metastatic setting chemotherapy regimens was 2 (0-5). Median number of cycles was 3 (1-20). There were 11 objective responses (23% [95%CI 12-37]) among 48 evaluable patients. Median progression-free survival and overall survival (OS) were 4.2 (95%CI: 2.8-5.3) and 6.9 (4.2-10.7) months respectively, with a one-year OS rate of 32% (20-46). Median Relative Dose Intensity for BCNU and MTX were 0.98 (0.31-1.1) and 0.96 (0.57-1.66) respectively. There were 2 presumed treatment-related deaths. One patient developed febrile neutropenia. Performance status, BS-BM score and presence of liver metastases were associated with OS in univariate analysis.
Conclusions: This combination appears to be effective and well tolerated in good performance status BC patients presenting with BM.
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| http://dx.doi.org/10.1186/1471-2407-10-257 | DOI Listing |
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