Bonadonna G, Brusamolino E, Valagussa P, Rossi A, Brugnatelli L, Brambilla C, De Lena M, Tancini G, Bajetta E, Musumeci R, Veronesi U
N Engl J Med. 1976 Feb 19;294(8):405-10. doi: 10.1056/NEJM197602192940801.
Prolonged cyclic combination chemotherapy with cyclophosphamide, methotrexate and fluorouracil was evaluated as adjuvant treatment to radical mastectomy in primary breast cancer with positive axillary lymph nodes. After 27 months of study, treatment occurred in 24 per cent of 179 control patients and in 5.3 per cent of 207 women given combination chemotherapy (P less than 10(-6)), the advantage appearing statistically significant in all subgroups of patients. Patients with four or more positive axillary nodes had a higher per cent of relapses than those with fewer nodes. The initial new clinical manifestations occurred in distant sites in 81.5 per cent of relapsed patients. Long-term chemotherapy produced an acceptable toxicity, thus allowing the administration of a high percentage of drug dosage. These results should be considered with caution, since, at present, the effect of this therapy on survival and possible long-term side effects remain unknown.
对环磷酰胺、甲氨蝶呤和氟尿嘧啶进行长期循环联合化疗，作为腋窝淋巴结阳性的原发性乳腺癌根治性乳房切除术的辅助治疗进行了评估。经过27个月的研究，179名对照患者中有24%出现治疗相关情况，而接受联合化疗的207名女性中有5.3%出现治疗相关情况（P小于10^(-6)），在所有患者亚组中该优势在统计学上均具有显著性。腋窝淋巴结阳性数为4个或更多的患者复发率高于淋巴结数较少的患者。81.5%的复发患者最初的新临床表现出现在远处部位。长期化疗产生了可接受的毒性，因此能够给予较高百分比的药物剂量。由于目前这种疗法对生存的影响以及可能的长期副作用尚不清楚，这些结果应谨慎看待。
