Davidson Nancy E
Johns Hopkins Oncology Center, Baltimore, MD 21231-1000, USA.
Clin Breast Cancer. 2002 Oct;3 Suppl 2:S53-8. doi: 10.3816/cbc.2002.s.012.
The use of systemic adjuvant therapy in women with early-stage breast cancer has been demonstrated to have a profound impact on survival. The role of paclitaxel and docetaxel in the adjuvant setting has attracted a great deal of attention. Both of these agents are highly active in patients with advanced breast cancer. In addition, they can be utilized in combination with anthracyclines, which have been shown to provide a slightly better outcome in patients with early-stage breast cancer compared to non-anthracycline-containing regimens. Randomized trials have demonstrated a potential role for paclitaxel in adjuvant chemotherapy. In the Cancer and Leukemia Group B 9344 trial, which explored the use of doxorubicin and cyclophosphamide with or without paclitaxel, the initial analysis demonstrated a 22% reduction in the relative risk of relapse and a 26% reduction in the relative risk of death in the paclitaxel group. However, a clear role for the use of paclitaxel in adjuvant therapy remains to be defined. The Breast Cancer International Research Group trial 001 compared the combination of docetaxel/doxorubicin/cyclophosphamide to 5-fluorouracil/doxorubicin/cyclophosphamide. This trial demonstrated a promising reduction in the relative risk of recurrence of 32% for the docetaxel/doxorubicin/cyclophosphamide group. Ongoing trials will help to further define the role of taxanes in the adjuvant setting for patients with operable breast cancer.
已证明对早期乳腺癌女性使用全身辅助治疗对生存有深远影响。紫杉醇和多西他赛在辅助治疗中的作用引起了广泛关注。这两种药物在晚期乳腺癌患者中都具有高度活性。此外，它们可与蒽环类药物联合使用，与不含蒽环类药物的方案相比，蒽环类药物已被证明在早期乳腺癌患者中能提供稍好的治疗效果。随机试验已证明紫杉醇在辅助化疗中的潜在作用。在癌症与白血病B组9344试验中，该试验探索了使用阿霉素和环磷酰胺加或不加紫杉醇的情况，初步分析表明紫杉醇组的复发相对风险降低了22%，死亡相对风险降低了26%。然而，紫杉醇在辅助治疗中的明确作用仍有待确定。乳腺癌国际研究组试验001比较了多西他赛/阿霉素/环磷酰胺组合与5-氟尿嘧啶/阿霉素/环磷酰胺。该试验表明多西他赛/阿霉素/环磷酰胺组的复发相对风险有希望降低32%。正在进行的试验将有助于进一步确定紫杉烷类药物在可手术乳腺癌患者辅助治疗中的作用。
