Berruti A, Bitossi R, Gorzegno G, Bottini A, Generali D, Milani M, Katsaros D, Rigault de la Longrais I A, Bellino R, Donadio M, Ardine M, Bertetto O, Danese S, Sarobba M G, Farris A, Lorusso V, Dogliotti L
Oncologia Medica, Azienda Ospedaliera San Luigi, Regione Gonzole 10, 10043 Orbassano (TO), Italy.
Br J Cancer. 2005 Feb 28;92(4):634-8. doi: 10.1038/sj.bjc.6602335.
We investigated the activity and toxicity of a combination of vinorelbine (VNB), paclitaxel (PTX) and 5-fluorouracil (5-FU) continuous infusion administered as first-line chemotherapy in metastatic breast cancer patients pretreated with adjuvant anthracyclines. A total of 61 patients received a regimen consisting of VNB 25 mg m(-2) on days 1 and 15, PTX 60 mg m(-2) on days 1, 8 and 15 and continuous infusion of 5-FU at 200 mg m(-2) every day. Cycles were repeated every 28 days. Disease response was evaluated by both RECIST and World Health Organization (WHO) criteria. Objective responses were recorded in 39 of 61 patients (64.0%) assessed by WHO and in 36 of 50 patients (72.0%) assessable by RECIST criteria. Complete remission occurred in 15 (24.6%) and 14 patients (28.0%), respectively. The median time to progression and overall survival of entire population was 10.6 and 27.3 months, respectively, and median duration of complete response was 14.8 months. The dose-limiting toxicity was myelosuppression (leucopenia grade 3/4 in 52.5% of patients). Grade 3/4 nonhaematologic toxicities included mucositis/diarrhoea in 13.1%, skin in 3.3% and cardiac in 1.6% of patients. Grade 2/3 neurotoxicity was observed in five patients (7.2%). The VNB, PTX and 5-FU continuous infusion combination regimen was active and manageable. Complete responses were frequent and durable.
我们研究了长春瑞滨(VNB)、紫杉醇(PTX)和5-氟尿嘧啶(5-FU)持续输注联合方案作为一线化疗在接受过蒽环类辅助治疗的转移性乳腺癌患者中的活性和毒性。共有61例患者接受了如下方案治疗:第1天和第15天给予VNB 25 mg/m²,第1、8和15天给予PTX 60 mg/m²,每天持续输注5-FU 200 mg/m²。每28天重复一个周期。采用实体瘤疗效评价标准(RECIST)和世界卫生组织(WHO)标准评估疾病反应。WHO评估的61例患者中有39例(64.0%)记录到客观反应,RECIST标准可评估的50例患者中有36例(72.0%)记录到客观反应。完全缓解分别发生在15例(24.6%)和14例(28.0%)患者中。总体人群的中位进展时间和总生存期分别为10.6个月和27.3个月,完全缓解的中位持续时间为14.8个月。剂量限制性毒性为骨髓抑制(52.5%的患者出现3/4级白细胞减少)。3/4级非血液学毒性包括13.1%的患者出现粘膜炎/腹泻、3.3%的患者出现皮肤毒性、1.6%的患者出现心脏毒性。5例患者(7.2%)观察到2/3级神经毒性。VNB、PTX和5-FU持续输注联合方案具有活性且易于管理。完全缓解频繁且持久。