Coskun U, Gunel N, Onuk E, Yilmaz E, Bayram O, Yamac D, Cihan A, Ucan B, Yildirim Y, Celenkoglu G, Ozkan S
Department of Medical Oncology, Gazi University Medical School, 06560 Ankara, Turkey.
Neoplasma. 2003;50(3):210-6.
In this retrospective study, we evaluated the results of 91 locally advanced breast cancer (LABC) patients (30 patients in stage IIIA - 33.0%, 61 patients in stage IIIB - 67.0%) who had been treated with different neoadjuvant chemotherapy regimens. Forty-three (47.3%) patients treated with FAC (5-Fluorouracil, doxorubicin, cyclophosphamide) or CA (cyclophosphamide, doxorubicin), 33 (36.3%) with FEC (5-Fluorouracil, epirubicin, cyclophosphamide) or CE (cyclophosphamide, epirubicin) and 15 (16.5%) with CMF (cyclophosphamide, methotrexate, 5-Fluorouracil) combination as neoadjuvant setting. Median follow-up duration was 33 (6-116) months in 91 patients. There was no significant difference in the pretreatment characteristics of patients receiving FAC/CA, FEC/CE and CMF including age, disease stage, menopausal and estrogen/progesteron receptor (ER/PR) status (p>0.05). In CMF group, no patient was treated with taxan as adjuvant setting. However, ten patients (30.3%) in FEC/CE group and 21 patients (48.8%) in FAC/CA group were treated with taxans. Overall response rate was lower in CMF group (60.0%), when compared to FEC/CE (81.9%) and FAC/CA (91.0%) groups (p<0.05). Median overall survival (OS) and diseases free survival (DFS) were similar in three groups; 28.0 months (range: 14.8-41.1) and 12.0 months (range: 5.3-18.6) in CMF, 45.0 months (range: 16.8-73.1) and 23.0 months (range: 0.0-48.6) in FEC/CE, 46.0 months (range: 41.1-50.8) and 22.0 months (range: 11.1-32.8) months in FAC/CA groups, respectively (p>0.05). In conclusion, overall response rates were found to be higher in anthracycline-based combinations than CMF, but these regimens had no additional survival advantage over CMF regimen. Long-term effects of these regimens should be investigated in further randomized trials.
在这项回顾性研究中，我们评估了91例局部晚期乳腺癌（LABC）患者（ⅢA期30例 - 33.0%，ⅢB期61例 - 67.0%）接受不同新辅助化疗方案的治疗结果。43例（47.3%）患者接受FAC（氟尿嘧啶、多柔比星、环磷酰胺）或CA（环磷酰胺、多柔比星）方案，33例（36.3%）接受FEC（氟尿嘧啶、表柔比星、环磷酰胺）或CE（环磷酰胺、表柔比星）方案，15例（16.5%）接受CMF（环磷酰胺、甲氨蝶呤、氟尿嘧啶）联合方案作为新辅助治疗。91例患者的中位随访时间为33（6 - 116）个月。接受FAC/CA、FEC/CE和CMF治疗的患者在年龄、疾病分期、绝经状态及雌激素/孕激素受体（ER/PR）状态等预处理特征方面无显著差异（p>0.05）。在CMF组中，没有患者接受紫杉烷类辅助治疗。然而，FEC/CE组有10例患者（30.3%），FAC/CA组有21例患者（48.8%）接受了紫杉烷类治疗。与FEC/CE组（81.9%）和FAC/CA组（91.0%）相比，CMF组的总体缓解率较低（60.0%）（p<0.05）。三组的中位总生存期（OS）和无病生存期（DFS）相似；CMF组分别为28.0个月（范围：14.8 - 41.1）和12.0个月（范围：5.3 - 18.6），FEC/CE组分别为45.0个月（范围：16.8 - 73.1）和23.0个月（范围：0.0 - 48.6），FAC/CA组分别为46.0个月（范围：41.1 - 50.8）和22.0个月（范围：11.1 - 32.8）（p>0.05）。总之，发现基于蒽环类的联合方案的总体缓解率高于CMF，但这些方案与CMF方案相比并无额外的生存优势。这些方案的长期影响应在进一步的随机试验中进行研究。
