[Effect of intra-arterial infusion of adriamycin on locally advanced primary breast cancer--third report. Clinical Study Group of Adriamycin for Breast Cancer in Japan].

The purpose of this study was to define the optimal dose and schedules for intra-arterial administration of adriamycin (ADR) in the treatment of locally advanced breast cancer. ADR was given intra-arterially to 110 patients with locally advanced breast cancer at a dose of 30 mg/time or 50 mg/time twice or once a week, respectively, with a total dose of 150 mg. The local effects and side effects of ADR as well as the prognosis were analysed in 91 evaluable cases. Overall response rates for ADR were as high as 62.2% (63/91) in the primary lesions and 80.0% (40/50) in metastatic lymph nodes. There was no difference in the response rate between cases receiving 30 mg and those receiving 50 mg at each infusion. However, a significantly higher response rate was noted, in patients infused ADR through both the subclavian and internal thoracic arteries (dual route group) in comparison with those infused through the subclavian artery alone (single route group). Histological effects of ADR on the primary lesion were assessed in accordance with the criteria proposed by Shimosato et al. Overall histological response rate (greater than Grade II b) was obtained in 29.4% (16/51), which was lower than the clinical effects. Histological effects were more potent in the 30 mg group than in the 50 mg group, but in relation to the route of administration, there was no significant difference between the groups. As for side effects, signs of systemic toxicity such as alopecia, leukopenia and gastrointestinal disorders were frequently observed, but there was no difference between the dose groups, and these side effects were considered to be tolerable. Prognostically, 50% survival time was 32.6 months, and the patients who received dual-route administration showed better survival.