Earl Helena, Iddawela Mahesh
University of Cambridge, Department of Oncology, Addenbrookes Hospital (Box 193), Cambridge, CB2 2QQ, UK.
Expert Rev Anticancer Ther. 2004 Apr;4(2):189-95. doi: 10.1586/14737140.4.2.189.
The past two decades have seen the introduction of routine adjuvant chemotherapy for early breast cancer. Since the cyclophosphamide, methotrexate and 5-fluorouracil (CMF) regimen was shown to improve disease-free and overall survival, adjuvant chemotherapy has become standard for many women. Anthracyclines, which are active in metastatic breast cancer, were then incorporated into adjuvant regimens and the meta-analysis of anthracycline trials has shown these regimens to be superior to CMF. Epirubicin (Ellence, Pharmacia), the 4'-epimer of doxorubicin, produces similar response rates to doxorubicin in the metastatic setting, and has been shown to have a better toxicity profile. In this review, the data relating to the efficacy of epirubicin in the adjuvant setting, including data from the recently presented National Epirubicin Adjuvant Trial, will be discussed.
在过去二十年中，早期乳腺癌常规辅助化疗开始应用。自从环磷酰胺、甲氨蝶呤和5-氟尿嘧啶（CMF）方案被证明可改善无病生存期和总生存期以来，辅助化疗已成为许多女性的标准治疗方法。对转移性乳腺癌有效的蒽环类药物随后被纳入辅助治疗方案，蒽环类药物试验的荟萃分析表明这些方案优于CMF。表柔比星（法玛西亚公司的Ellence）是阿霉素的4'-差向异构体，在转移性乳腺癌治疗中产生的缓解率与阿霉素相似，并且已被证明具有更好的毒性特征。在本综述中，将讨论表柔比星在辅助治疗中的疗效相关数据，包括最近公布的全国表柔比星辅助试验的数据。
