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A prospective randomized clinical trial of treatment with
vincristine, cyclophosphamide, methotrexate and 5-fluorouracil
after conventional curative treatment for stage II breast cancer is
described. The results at 2 years are recorded together with
details of toxicity. Future plans are discussed briefly.
Acknowledgement We wish to acknowledge the participation of all the
collaborators in this study, the co-ordinator Dr. ERICA MANSBACHER
and the support of Action Cancer in Belfast. References 1. Ahmann,
D. L. , O'Connell, M. J. , Hahn, R. G. , Bisel, H. F. , Lee, R. A.
, Edmonson, J. H. : An evaluation of early or delayed adjuvant
chemotherapy in premenopause1 patients with advanced breast cancer
undergoing oophorectomy. New Engl. J. Med. 297, 356-360 (1977) 2.
Ahmann, D. L. , Scanlon, P. W. , Bisel, H. F. , Edmonson, J. H. ,
Frytak, S. , Payne, W. S. , O'Fallon, J. R. , Hahn, R. J. , Ingle,
J. N. , O'Connell, M. J. , Rubin, J. : Repeated adjuvant
chemotherapy with Phenyl-alanine mustard, or 5-Fluorouracil,
Cyclophosphamide and Prednisone with or without radiation after
mastectomy for breast cancer. Lancet 1978//, 893-896 3. Bonadonna,
G. , Rossi, A. , Valagussa, P. , Banfi, A. , Veronesi, U. : The CMF
program for operable breast cancer with positive axillary nodes.
Cancer 39, 2904-2915 (1977) 4. Edelstyn, G. A. , Bates, T. S. ,
Brinkley, D. , Macrae, K. D. , Spittle, M. , Wheeler, T. :
Comparison of 5-day, I-day and 2-day cyclical combination
chemotherapy in advanced breast cancer.
P. Denoix and G. Mathe Approximately 70% of cancer patients relapse
after surgery before the 5th year and, in most cases, for example
in breast carcinoma, they relapse still later up to the 20th year.
For some considerable time, the strategy of cancer treatment has
been limited to the sophistication of surgery-radiotherapy
combinations that maximally decreased the incidence of local and
regional relapses in sites that were within their reach. Today, the
practice of clinical oncology is unthinkable without the active
participation of the medical oncologist. He is the "third man" of
the clinical oncology team, and he has recently focused attention
on the fact that most relapses arise from distant metastases due to
the proliferation of cells seeded there after having left the
primary tumor site at the time of operation and, hence, are
inaccessible to any form oflocal and/or regional treatment. On this
evidence, medical oncologists have proposed the application of
medical treatments for disseminated minimal residual disease (MRD).
They have two available means: chemother apy and immunotherapy.
Medical oncologists in general can be divided into three groups:
chemotherapists, immunotherapists, and chemoimmunotherapists. The
pure chemotherapists, who had already cured some malignant
neoplasias such as Hodgkin's disease, acute lymphoid leukemia,
placental choriocarcinoma, and Wilms' tumor, thought they might
have the means of attacking the residual disease of common
cancers."
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