{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T12:27:27Z","timestamp":1760099247086,"version":"3.40.4"},"reference-count":3,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[1999,1,1]],"date-time":"1999-01-01T00:00:00Z","timestamp":915148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[1999,1,1]],"date-time":"1999-01-01T00:00:00Z","timestamp":915148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Oncology"],"published-print":{"date-parts":[[1999]]},"abstract":"<jats:p>Escalating doses of cyclophosphamide were given every 3 weeks as adjuvant treatment for women operated for breast cancer to determine the maximum tolerated dose of cyclophosphamide that can be given with constant doses of methotrexate (40 mg\/m&lt;sup&gt;2&lt;\/sup&gt;) and 5-FU (600 mg\/m&lt;sup&gt;2&lt;\/sup&gt;; CMF) as an outpatient treatment without the routine use of granulocyte colony-stimulating growth factor (G-CSF). The dose of cyclophosphamide was increased by 250 mg\/m&lt;sup&gt;2&lt;\/sup&gt; starting from the dose of 1,000 mg\/m&lt;sup&gt;2&lt;\/sup&gt;. Mesna was given to prevent cystitis. The criteria for dose-limiting toxicity were grade IV granulocytopenia lasting for longer than 48\u00a0h, granulocytopenic infection or other grade IV toxicities. G-CSF and ofloxacin were used if grade IV granulocytopenia continued for longer than 48 h or if granulocytopenic infection occurred. At the dose level of 1,500 mg\/m&lt;sup&gt;2&lt;\/sup&gt; (500 mg\/m&lt;sup&gt;2&lt;\/sup&gt;\/week) 22 (92%) of the 24 patients had grade IV granulocytopenia during the 6 CMF cycles given, but only 3 (13%) had granulocytopenic fever. G-CSF was used in 28% of the cycles at this dose level. Other toxicities included complete alopecia (79%), nausea and vomiting. Sixteen (80%) of the premenopausal women became postmenopausal. At the dose level of 1,750 mg\/m&lt;sup&gt;2&lt;\/sup&gt; all 3 patients treated had to be hospitalized after the first cycle due to neutropenic infection (n = 2) or intractable vomiting even though prophylactic G-CSF was used. We conclude that intravenous CMF with a cyclophosphamide dose of 1,500 mg\/m&lt;sup&gt;2&lt;\/sup&gt; given at 3-week intervals with the selective use of prophylactic G-CSF is feasible as adjuvant treatment for patients with breast cancer.<\/jats:p>","DOI":"10.1159\/000011948","type":"journal-article","created":{"date-parts":[[2003,4,15]],"date-time":"2003-04-15T15:43:24Z","timestamp":1050421404000},"page":"103-109","source":"Crossref","is-referenced-by-count":1,"title":["Intensified Adjuvant Cyclophosphamide, Methotrexate and 5-Fluorouracil Therapy: A Dose-Finding Study for Ambulatory Patients with Breast Cancer"],"prefix":"10.1159","volume":"56","author":[{"given":"P.","family":"Hietanen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Teerenhovi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Joensuu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[1999,2,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199504063321401"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.273.7.542"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199405053301801"}],"container-title":["Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/11948","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/11948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:54:44Z","timestamp":1745470484000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000011948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999]]},"references-count":3,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1999,2,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000011948","archive":["Portico"],"relation":{},"ISSN":["0030-2414","1423-0232"],"issn-type":[{"type":"print","value":"0030-2414"},{"type":"electronic","value":"1423-0232"}],"subject":[],"published":{"date-parts":[[1999]]}}}