Espinosa E, Morales S, Borrega P, Casas A, Madroñal C, Machengs I, Illarramendi J A, Lizón J, Moreno J A, Belón J, Janáriz J, de la Puente M, Checa T, Mel J R, González Barón M
Oncopaz Cooperative Group, Madrid, Spain.
Cancer Chemother Pharmacol. 2004 Dec;54(6):546-52. doi: 10.1007/s00280-004-0830-1. Epub 2004 Aug 17.
Epirubicin and docetaxel are two of the most active drugs against breast carcinoma. As the achievement of a pathological complete response (pCR) is important for survival of patients with locally advanced disease, we used both drugs as neoadjuvant chemotherapy.
Women with locally advanced or inflammatory breast cancer received epirubicin 120 mg/m2 followed by docetaxel 75 mg/m2, both on day 1, every 21 days for four cycles. Lenograstim was administered for 10 days in all cycles.
Of 51 patients included, 50 received a total of 188 cycles, with a median of 4 per patient. The median age was 47 years, tumour stage was IIIA in 14 patients and IIIB in 36. Oestrogen receptors were positive in 65% of tumours. There were 10 clinical complete responses (20%) and 29 partial responses (58%). Surgery consisted of mastectomy in 40 patients and tumorectomy in 6. After surgery, 9 pCR were recorded (18%). One patient progressed and died soon after the end of chemotherapy. After a median follow-up of 22 months, the median disease-free survival was 33.7 months. Grade 3/4 neutropenia was observed in 32% of patients, anaemia in 6%, and thrombocytopenia in 4%. Five patients had febrile neutropenia. There were no toxic deaths or grade 4 nonhaematological toxicities.
Docetaxel plus high-dose epirubicin showed promising activity in patients with locally advanced and inflammatory breast cancer, at the cost of moderate toxicity.
表柔比星和多西他赛是治疗乳腺癌最有效的两种药物。由于实现病理完全缓解（pCR）对局部晚期疾病患者的生存至关重要，我们将这两种药物用作新辅助化疗。
局部晚期或炎性乳腺癌女性患者在第1天接受表柔比星120mg/m²，随后接受多西他赛75mg/m²，每21天为一个周期，共四个周期。所有周期均给予10天的来格司亭。
纳入的51例患者中，50例共接受了188个周期的治疗，每位患者的中位数为4个周期。中位年龄为47岁，14例患者肿瘤分期为IIIA期，36例为IIIB期。65%的肿瘤雌激素受体呈阳性。有10例临床完全缓解（20%）和29例部分缓解（58%）。40例患者接受了乳房切除术，6例接受了肿瘤切除术。术后记录到9例pCR（18%）。1例患者在化疗结束后不久病情进展并死亡。中位随访22个月后，无病生存期的中位数为33.7个月。32%的患者出现3/4级中性粒细胞减少，6%出现贫血，4%出现血小板减少。5例患者发生发热性中性粒细胞减少。没有出现毒性死亡或4级非血液学毒性。
多西他赛加用高剂量表柔比星在局部晚期和炎性乳腺癌患者中显示出有前景的活性，但代价是有中度毒性。
