P Gupta, L Bijlani, G K Rath, A Misra, M C Mishra, N K Shukla, A Kriplani, B M Kapur
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引用次数: 1
摘要
69例患者中位年龄45岁,其中62.3%为绝经前,局部晚期乳腺癌(T 4, N 0-3, M 0;IIIb期)接受新辅助治疗环磷酰胺、阿霉素和5-氟尿嘧啶3个周期(CAF组36例)或环磷酰胺、甲氨蝶呤和5-氟尿嘧啶3个周期(CMF组33例)。完全缓解或残留病灶直径小于2cm的患者行根治性放疗,残留病灶较多的患者行根治性乳房切除术。给予9个周期的辅助化疗。与CMF相比,CAF术后更常观察到完全缓解和通过完全保留乳房的放疗控制疾病,分别为25%对3% (p = 0.025)和48.5%对12% (p = 0.002)。两种治疗方案的总有效率、不良反应、放疗/手术后的疾病控制、局部复发和转移相似。复发患者年轻,中位年龄为38岁,68.4%的复发发生在转移部位,42%的复发发生在辅助化疗期间。本研究表明,在局部晚期乳腺癌中,与新辅助CMF和放疗相比,新辅助CAF和放疗后更大比例的患者可以实现无病。
Neoadjuvant chemotherapy with cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) or cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in 69 cases of locally advanced (stage IIIb) breast cancer.
Sixty nine patients with a median age of 45 years, 62.3 per cent of whom were premenopausal, with locally advanced breast cancer (T 4, N 0-3, M 0; Stage IIIb) were treated with 3 cycles of either neoadjuvant cyclophosphamide, doxorubicin and 5-fluorouracil, being the CAF group: 36 patients, or cyclophosphamide, methotrexate and 5-fluorouracil, being the CMF group: 33 patients. Patients achieving complete response or with residual disease of less than 2 cm in diameter received radical radiotherapy while those with more residual disease underwent radical mastectomy. Nine cycles of adjuvant chemotherapy were administered. Complete responses and disease control by radiotherapy with complete breast preservation were more frequently observed after CAF than CMF, being 25 per cent vs 3 per cent (p = 0.025) and 48.5 per cent vs 12 per cent (p = 0.002), respectively. Overall response rates, adverse effects, disease control following radiotherapy/surgery, local relapses and metastases were similar for both regimes. Relapsing patients were young, with a median age of 38 years, 68.4 per cent of relapses occurred at metastatic sites and 42 per cent of relapses occurred during adjuvant chemotherapy. This study suggests that in locally advanced breast cancer, a greater proportion of patients can be rendered disease free after neoadjuvant CAF and radiotherapy compared to neoadjuvant CMF and radiotherapy.