Kier P, Ruckser R, Buxhofer V, Habertheuer K H, Zelenka P, Tatzreiter G, Hübl G, Kittl E, Hauser A, Sebesta C, Hinterberger W
2. Medizinischen Abteilung des Donauspitals und dem Ludwig Boltzman-Institut für Stammzelltransplantation im SMZ-Ost der Stadt Wien.
Acta Med Austriaca Suppl. 2000;52:33-6.
42 breast cancer patients were treated by high-dose chemotherapy (HDC) and autologous peripheral stem-cell transplantation (ASTx) in the Donauspital between 1992 and 1999. 24 patients had stage II/III breast cancer with high risk for relapse. The other 18 patients underwent HDC and ASTx in chemosensitive stage IV. After previous conventional chemotherapy peripheral stem-cells were harvested by one cycle of mobilisation chemotherapy (epirubicin/taxol, FEC 120 or cyclophosphamide) followed by cytokine stimulation. 16 patients were treated by a tandem transplantation (conditioning protocol for 1st ASTx was melphalan 200 mg/m2 and for 2nd transplant it was CTC: cyclophosphamide 6 g/m2; thiotepa 500 mg/m2; carboplatin 800 mg/m2). The other 26 patients received one HDC with CTC as conditioning protocol. The HDC was well tolerated by all patients, there was no transplant-related mortality. The median survival and the progression-free survival (PFS) after HDC and ASTx in stage IV breast cancer patients were 28 and 11 months, respectively. The median survival and PFS were not yet reached in stage II/III patients after 55 months. The actuarial survival and PFS in that patient group were 70% after 55 months. Our data confirm the low risk and good efficacy of HDC and ASTx in breast cancer patients. Nevertheless randomised studies are necessary to evaluate the importance of HDC compared to intensified conventional protocols without ASTx.
1992年至1999年间，多瑙医院对42例乳腺癌患者进行了大剂量化疗（HDC）和自体外周干细胞移植（ASTx）。24例患者患有复发风险高的II/III期乳腺癌。另外18例患者在化疗敏感的IV期接受了HDC和ASTx。在先前的传统化疗后，通过一个周期的动员化疗（表柔比星/紫杉醇、FEC 120或环磷酰胺），随后进行细胞因子刺激来采集外周干细胞。16例患者接受了串联移植（第一次ASTx的预处理方案为美法仑200mg/m²，第二次移植的预处理方案为CTC：环磷酰胺6g/m²；噻替派500mg/m²；卡铂800mg/m²）。另外26例患者接受了以CTC为预处理方案的一次HDC。所有患者对HDC耐受性良好，无移植相关死亡。IV期乳腺癌患者HDC和ASTx后的中位生存期和无进展生存期（PFS）分别为28个月和11个月。II/III期患者在55个月后尚未达到中位生存期和PFS。该患者组55个月后的精算生存率和PFS为70%。我们的数据证实了HDC和ASTx在乳腺癌患者中的低风险和良好疗效。然而，有必要进行随机研究以评估HDC与无ASTx的强化传统方案相比的重要性。
