可手术乳腺癌的新辅助化疗

S.M. Scholl , B. Asselain , T. Palangie , T. Dorval , M. Jouve , E. Garcia Giralt , J. Vilcoq , J.C. Durand , P. Pouillart
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引用次数: 246

摘要

局部乳腺癌的原发性化疗可以防止手术治疗过程中肿瘤的扩散,减少微转移的增殖。1983年11月,居里研究所开始了一项随机临床试验,对196名绝经前和绝经后可手术(T2-3, N0-1b)乳腺癌患者进行了比较,以新辅助和辅助化疗方案与放疗方案进行手术或不手术。随访35 ~ 70个月(中位54个月)。新辅助组在局部治疗前接受2个月周期静脉注射阿霉素/环磷酰胺/5-氟尿嘧啶,随后接受4个月周期静脉注射。辅助组在局部治疗后6个月为一个周期。由于纳入了绝经后和/或淋巴结阴性患者,39例患者的依从性不是最佳的,这些患者根据接受的实际剂量单独分析。在两个新辅助化疗周期后评估的肿瘤反应与剂量显著相关(P = 0.003)。新辅助治疗组的生存表现出轻微的非显著优势。实际剂量绘制的生存率也相似。新辅助化疗是安全的,至少与辅助方案一样有效。患者已经累积到后续更大规模的化疗作为一线治疗的试验中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neoadjuvant chemotherapy in operable breast cancer

Primary chemotherapy in localised breast cancer may prevent tumour spread during surgical treatment and reduce proliferation of micrometastases. A randomised clinical trial, in 196 premenopausal and postmenopausal patients with operable (T2-3, N0-1b) breast cancer, was started in November 1983 at the Institut Curie to compare neoadjuvant and adjuvant regimens of chemotherapy with radiotherapy with or without surgery. The patients have been followed up for 35–70 months (median 54). A neoadjuvant group received two monthly cycles of intravenous doxorubicin/cyclophosphamide/5-fluorouracil before locoregional therapy and four cycles subsequently. Six months cycles following locoregional therapy were administered to the adjuvant group. Because of inclusion of postmenopausal and/or node-negative patients, compliance was less than optimal in 39 patients who were analysed separately according to actual dose received. Tumour response, evaluated after two cycles of neoadjuvant chemotherapy, was significantly associated with dose (P = 0.003). Survival showed a slight non-significant advantage for the neoadjuvant group. Survival plotted by actual dose was also similar. Neoadjuvant chemotherapy was safe and at least as effective as the adjuvant regimen. Patients have been accrued to a subsequent larger trial of chemotherapy as first-line treatment.

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