Adjuvant chemotherapy (CMF) for breast carcinoma. Patient's compliance and total dose achieved

Seventy-five patients accepted postmastectomy adjuvant CMF chemotherapy for Stage II and III carcinoma of the breast. All patients, irrespective of age, were started on the same drug dosages. About 77% of the patients stayed on the treatment for at least 6 months, and 50%, for 12 or more months (compliance rate unrelated to age). Among the 58 patients who received 6 or more cycles of CMF, 12 (21%) actually received more than 85% of the planned mean total dose (MTD). Adjuvant CMF doses had to be reduced for toxicity related to drug (52% of patients) and reasons not related to drug (27%). Premenopausal patients are more likely to skip cycle due to personal reasons and to have leukopenia, while postmenopausal patients are more likely to have gastrointestinal toxicity and flu-like syndromes. Theoretically, excluding nondrug-related side effects, only 30-40% of the patients can receive over 85% of the planned dose of CMF adjuvant chemotherapy.