Becher R, Höfeler H, Kloke O, May D, Wandl U, Niederle N, Richter R, Scheulen M E, Schmidt C G
Innere Universitäts- und Poliklinik (Tumorforschung), Westdeutsches Tumorzentrum, Essen, BRD.
Oncology. 1991;48(6):459-63. doi: 10.1159/000226981.
A total of 51 fully evaluable patients with advanced and intensively pretreated breast cancer were treated with a combination chemotherapy of ifosfamide plus mesna, methotrexate and 5-fluorouracil. All patients had received at least one series of combined chemotherapy, 30 patients had received more than one combination and 41 patients had had anthracyclines before. Metastatic lesions in more than one site were found in 42 patients, and 24 patients had metastatic liver lesions. Partial remission was achieved in 10 patients (20%) and no change in 16 patients (31%). Survival was almost identical in both groups of responding patients and significantly shorter in treatment failures. Response was favorable in patients without pretreatment with anthracyclines. Two patients who received this protocol directly after progression with cyclophosphamide, methotrexate and 5-fluorouracil (CMF protocol) responded with a partial remission. Median time to progression was 7 months for partial responders and 4.5 months for patients achieving a no-change status. Median survival was 8 months for all patients. Toxicity was tolerable. Leukocytopenia and thrombocytopenia were treatment-limiting parameters. Overall, this protocol is well tolerable and effective in breast cancer patients with advanced disease and in intensively pretreated patients.
共有51例晚期且经过强化预处理的乳腺癌患者接受了异环磷酰胺加美司钠、甲氨蝶呤和5-氟尿嘧啶的联合化疗。所有患者均接受过至少一个疗程的联合化疗，30例患者接受过不止一种联合化疗方案，41例患者曾接受过蒽环类药物治疗。42例患者发现有一个以上部位的转移病灶，24例患者有肝转移病灶。10例患者（20%）达到部分缓解，16例患者（31%）病情无变化。两组缓解患者的生存期几乎相同，治疗失败患者的生存期明显较短。未接受过蒽环类药物预处理的患者缓解情况良好。2例在接受环磷酰胺、甲氨蝶呤和5-氟尿嘧啶（CMF方案）治疗进展后直接接受本方案治疗的患者出现部分缓解。部分缓解患者的中位疾病进展时间为7个月，病情无变化患者为4.5个月。所有患者的中位生存期为8个月。毒性反应可耐受。白细胞减少和血小板减少是限制治疗的参数。总体而言，该方案对于晚期乳腺癌患者和经过强化预处理的患者耐受性良好且有效。
