Dillman Robert O, Barth Neil M, VanderMolen Louis A, Allen Kanoe, Beutel Linda D, Chico Sherri
Hoag Cancer Center, Newport Beach, California 92658, USA.
Am J Clin Oncol. 2005 Jun;28(3):281-8. doi: 10.1097/01.coc.0000156917.43490.65.
During 1990-1999, we treated 60 patients with breast cancer who had distant metastases with high-dose chemotherapy and autologous stem cell rescue (HDC) after they had responded to induction chemotherapy. HDC regimens were MiTepa (60 mg/m2 mitoxantrone by continuous intravenous infusion over 3 days plus 300 mg/m2 thiotepa intravenously over 2 hours daily x 3 days) and ICE (12 g/m2 ifosfamide, 1800 mg/m2 carboplatin, 2 g/m2 etoposide; all 3 by continuous intravenous over 4 days). At a median follow up >8 years, the median failure-free survival (FFS) was 13.9 months, median overall survival (OS) 29.1 months, 5-year FFS 12%s and 5-year OS 25%. Thirty-three patients underwent tandem (T) transplants; 27 underwent a single (S) HDC. Median ages for these 2 groups were 45 and 48 years; bone and liver metastases were more prevalent in the T cohort, whereas lung metastases were more prevalent in the S cohort. At a median follow up of 6.5 years for the S group and >9 years for the T group, there were 52 deaths. FFS was better for T: median 15.7 versus 7.7 months (p2 = 0.010) as was OS: median 32.7 versus 17.7 months, 2-year survival 68% versus 41%, and 5-year survival 32% versus 15% (p2 = 0.010). As a group, patients with distant metastatic breast cancer who underwent tandem transplants had a better posttransplant survival than patients who underwent a single HDC.
1990年至1999年期间，我们对60例远处转移的乳腺癌患者进行了治疗，这些患者在诱导化疗有反应后接受了大剂量化疗和自体干细胞救援（HDC）。HDC方案为米托蒽醌（米托蒽醌60mg/m²，连续静脉输注3天，加硫替派300mg/m²，静脉滴注2小时，每日×3天）和ICE方案（异环磷酰胺12g/m²、卡铂1800mg/m²、依托泊苷2g/m²；全部3种药物连续静脉输注4天）。中位随访时间>8年，中位无失败生存期（FFS）为13.9个月，中位总生存期（OS）为29.1个月，5年FFS为12%，5年OS为25%。33例患者接受了串联（T）移植；27例接受了单次（S）HDC。这两组的中位年龄分别为45岁和48岁；骨和肝转移在T组中更常见，而肺转移在S组中更常见。S组中位随访6.5年，T组>9年，共有52例死亡。T组的FFS更好：中位值为15.7个月对7.7个月（p2=0.010），OS也是如此：中位值为32.7个月对17.7个月，2年生存率为68%对41%，5年生存率为32%对15%（p2=0.010）。总体而言，接受串联移植的远处转移性乳腺癌患者移植后的生存率优于接受单次HDC的患者。
