环磷酰胺、甲氨蝶呤和氟尿嘧啶(CMF)与醋酸亮丙瑞林激素去势作为淋巴结阳性绝经前乳腺癌患者辅助治疗的比较:TABLE研究(武田醋酸亮丙瑞林辅助乳腺癌研究)的初步结果

Cyclophosphamide, methotrexate and fluorouracil (CMF) versus hormonal ablation with leuprorelin acetate as adjuvant treatment of node-positive, premenopausal breast cancer patients: preliminary results of the TABLE-study (Takeda Adjuvant Breast cancer study with Leuprorelin Acetate).

作者信息

Schmid Peter, Untch Michael, Wallwiener Diethelm, Kossé Valentin, Bondar Grigorij, Vassiljev Leonid, Tarutinov Valerie, Kienle Erika, Lüftner Diana, Possinger Kurt

机构信息

Medizinische Klinik mit Schwerpunkt Onkologie und Hämatologie, Humboldt Universität zu Berlin, Germany.

出版信息

Anticancer Res. 2002 Jul-Aug;22(4):2325-32.

DOI:
Abstract

PURPOSE

The objective of this study was to evaluate the efficacy and tolerability of leuprorelin acetate in adjuvant treatment in comparison to standard chemotherapy with CMF in premenopausal, estrogen-receptor-positive or unknown, node-positive patients with early breast cancer.

PATIENTS AND METHODS

The patients were randomly assigned to receive either 2 years of hormone ablation with leuprorelin acetate 11.25 mg as a subcutaneous injection every three months or six courses of CMF (cyclophosphamide 500 mg/m2, methotrexate 40 mg/m2, fluorouracil 600 mg/m2, days 1 and 8, q 4 weeks). The primary study end-point was recurrence-free survival (RFS) after 2 years. Secondary end-points included overall survival, adverse events and hormonal suppression.

RESULTS

Between 1995 and 1999, a total of 589 patients with breast cancer were randomized to treatment with leuprorelin acetate or CMF. The data of 227 patients were available for this first interim analysis. One hundred and ten and 117 patients were assigned to leuprorelin acetate and chemotherapy, respectively. Both treatment arms were well balanced for baseline characteristics. So far, no difference between the groups has emerged with respect to recurrence-free or overall survivaL Suppression of serum estradiol levels and menstruation was less marked in the CMF-group compared to the leuprorelin arm. The most common adverse events were low-grade hot flushes, weight gain and increased sweating in the leuprorelin-treated patients and alopecia, nausea and vomiting in the CMF-group.

CONCLUSION

According to these preliminary results, ovarian suppression with leuprorelin acetate was as effective as standard chemotherapy for premenopausal women with hormone-sensitive, node-positive early breast cancer.

摘要

目的

本研究的目的是评估醋酸亮丙瑞林在辅助治疗中的疗效和耐受性,并与环磷酰胺、甲氨蝶呤、氟尿嘧啶(CMF)标准化疗方案对比,用于绝经前、雌激素受体阳性或未知、淋巴结阳性的早期乳腺癌患者。

患者与方法

患者被随机分配,分别接受为期2年的激素消融治疗,即每三个月皮下注射11.25mg醋酸亮丙瑞林,或接受六个疗程的CMF方案(环磷酰胺500mg/m²、甲氨蝶呤40mg/m²、氟尿嘧啶600mg/m²,第1天和第8天用药,每4周重复一次)。主要研究终点为2年后的无复发生存期(RFS)。次要终点包括总生存期、不良事件和激素抑制情况。

结果

1995年至1999年间,共有589例乳腺癌患者被随机分配接受醋酸亮丙瑞林或CMF治疗。本首次中期分析可获取227例患者的数据。分别有110例和117例患者被分配接受醋酸亮丙瑞林治疗和化疗。两个治疗组的基线特征均衡良好。到目前为止,两组在无复发生存期或总生存期方面未出现差异。与醋酸亮丙瑞林组相比,CMF组血清雌二醇水平和月经的抑制作用较弱。醋酸亮丙瑞林治疗的患者中最常见的不良事件为轻度潮热、体重增加和出汗增多,CMF组为脱发、恶心和呕吐。

结论

根据这些初步结果,对于激素敏感、淋巴结阳性的绝经前早期乳腺癌女性,醋酸亮丙瑞林的卵巢抑制作用与标准化疗效果相当。

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