Please, can a doctor respond?

[Laurie252]

I just completed chemotherapy: 1 infusion of Cytoxan & Taxotere, 6 infusions of CMF.  My chemo was changed to CMF when I had a severe allergic reaction after the taxotere infusion and a shot of Neulasta.  Because it was unclear whether the reaction was due to Taxotere or Neulasta, it was decided I should have neither and I was switched to CMF.  But without the Neulasta, my white blood cell count dropped too much after one CMF infusion, so the CMF dose was reduced to 85% and the cycle was extended from 3 weeks to 4 weeks from infusion to infusion. Then, for the remaining 5 infusions, my dose was dropped to 75% and I remained on the 4-week cycle.  I have a great oncologist and I know he made the best decisions possible in the circumstances.  I also know that dose reductions are a gray area in which there may be no definitive answers, and that I am asking a question about the treatment plan after the fact.  Nonetheless, I wonder if the chemo levels I received were enough to "do the job," so to speak?Can any of the doctors who respond on this website talk from their own professional experience? (I had stage 1 tumor, 1 cm., grade 3, negative lymph nodes, E.R. positive, HER2 negative, and no cancer cells found in tissue surrounding tumor.  I had lumpectomy and sentinel node biopsy.  My oncotype dx score was 29.) Thanks.  

[Laurie252]

Thanks very much.

[HeinrikMD]

Hi,
I think you've received adequate treatment.
Bear in mind that while there is a proposed dosage for the drugs, receiving the 100% of the intended is ideal, but departures are not necessarily associated with poorer outcomes. The 85% of original planned dosage for CMF is specifically known to be the within the limits of benefit not significantly different from the full 100% dose.
Stay positive.