Shi Y, Pan F, Han X
Department of Medical Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021.
Zhonghua Yi Xue Za Zhi. 1999 Dec;79(12):890-3.
To evaluate the therapeutic effectiveness and safety of combined high-dose chemotherapy (HDC) with autologous hematopoietic stem cell transplantation (AHSCT) for recurrent and high-risk breast cancer.
Thirteen patients with recurrent or high-risk breast cancer underwent HDC with AHSCT. Seven cases had relapsed metastasis who had failed in the previous chemotherapy. Two cases had stage IV disease who had received palliative excision. Four cases had stage II or III breast cancer with over 10 positive axillary lymph nodes who had received radical surgical resection. Four cases received autologous bone marrow transplantation, and six received autologous peripheral blood stem cell transplantation. The consolidation regimen was Thiotepa 500 (250-604) mg/m2, Cyclophosphamide 4.9 (3.3-6.0) g/m2. Eight cases were also given Carboplatin 800 (400-800) mg/m2, and two received Etoposide 830 (800-830) mg/m2 instead of Thiotepa in the consolidation regimen. Twelve cases underwent endocrinotherapy after HDC with AHSCT, six operated cases underwent radiotherapy in the area of chest wall and regional lymph nodes after HDC with AHSCT.
After a median follow-up of 8(1-47) months, four cases achieved complete remission (CR) and 3 achieved partial remission (PR) in the 7 cases with relapsed metastasis after induction of chemotherapy, PR patients achieved CR after HDC with AHSCT. The disease free survival (DFS) was 1-31 months in these 7 cases. One of two stage IV cases achieved CR and the other had progressive disease (PD) after induction chemotherapy, but the PD patient achieved PR after HDC with AHSCT, they underwent local radiotherapy after HDC with AHSCT and DFS was 5 and 22 months, respectively. The DFS was from 1-47 months in 4 cases with stage II or III disease.
HDC with AHSCT is a highly potential therapeutic means for recurrent and high-risk breast cancer paitents.
评估大剂量联合化疗（HDC）与自体造血干细胞移植（AHSCT）治疗复发及高危乳腺癌的疗效和安全性。
13例复发或高危乳腺癌患者接受了HDC联合AHSCT治疗。7例为复发转移患者，先前化疗失败；2例为IV期疾病患者，接受了姑息性切除；4例为II期或III期乳腺癌患者，腋窝淋巴结阳性超过10个，接受了根治性手术切除。4例接受自体骨髓移植，6例接受自体外周血干细胞移植。巩固方案为：噻替派500（250 - 604）mg/m²，环磷酰胺4.9（3.3 - 6.0）g/m²。8例还给予卡铂800（400 - 800）mg/m²，2例在巩固方案中用依托泊苷830（800 - 830）mg/m²替代噻替派。12例患者在HDC联合AHSCT后接受内分泌治疗，6例手术患者在HDC联合AHSCT后接受胸壁及区域淋巴结放疗。
中位随访8（1 - 47）个月后，7例复发转移患者在诱导化疗后，4例达到完全缓解（CR），3例达到部分缓解（PR），PR患者在HDC联合AHSCT后达到CR。这7例患者的无病生存期（DFS）为1 - 31个月。2例IV期患者中，1例在诱导化疗后达到CR，另1例病情进展（PD），但PD患者在HDC联合AHSCT后达到PR，他们在HDC联合AHSCT后接受了局部放疗，DFS分别为5个月和22个月。4例II期或III期疾病患者的DFS为1 - 47个月。
HDC联合AHSCT是复发及高危乳腺癌患者极具潜力的治疗手段。
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