Jungi W F, Senn H J
Medizinische Klinik C, Kantonsspital, St. Gallen, Switzerland.
J Natl Cancer Inst Monogr. 1992(11):71-6.
Women with node-negative breast cancer have a 30% chance of relapse 5 years after mastectomy. If it is possible to prevent or defer recurrent disease with adjuvant systemic therapy, node-negative patients, with their low tumor burden, should theoretically benefit most from such treatment. In 1974 we started a randomized adjuvant trial in eastern Switzerland, using a subjectively less toxic regimen [chlorambucil, methotrexate, and fluorouracil (LMF)]. Two hundred fifty-four patients were randomly assigned after standardized modified radical mastectomy to observation only or to treatment with oral LMF for 6 months followed by BCG skin scarifications monthly for up to 2 years. While we find no significant statistical difference between the control group and the treated group in terms of relapse-free survival, there is a strong and consistent trend toward prolongation of overall survival within the treated group.
淋巴结阴性的乳腺癌女性患者在乳房切除术后5年有30%的复发几率。如果有可能通过辅助性全身治疗预防或推迟复发性疾病，那么淋巴结阴性且肿瘤负荷较低的患者理论上应能从这种治疗中获益最多。1974年，我们在瑞士东部开展了一项随机辅助试验，采用了一种主观上毒性较小的治疗方案[苯丁酸氮芥、甲氨蝶呤和氟尿嘧啶（LMF）]。254例患者在接受标准化改良根治性乳房切除术后，被随机分配至仅观察组或接受口服LMF治疗6个月，随后每月进行卡介苗皮肤划痕接种，持续长达2年。虽然我们发现对照组和治疗组在无复发生存方面没有显著的统计学差异，但治疗组在总生存延长方面有强烈且一致的趋势。
