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聚腺苷酸-聚尿苷酸联合局部区域及盆腔放疗与CMF化疗作为可手术乳腺癌辅助治疗的比较。法国癌症中心联合会(F.F.C.C.)一项随机试验的6年半随访分析

Polyadenylic-polyuridylic acid plus locoregional and pelvic radiotherapy versus chemotherapy with CMF as adjuvants in operable breast cancer. A 6 1/2 year follow-up analysis of a randomized trial of the French Federation of Cancer Centers (F.F.C.C.).

作者信息

Lacour J, Laplanche A, Delozier T, Berlie J, Mourali N, Julien J P, De Gislain C, Namer M, Petit J C, Denis V

机构信息

Institut Gustave-Roussy, Villejuif, France.

出版信息

Breast Cancer Res Treat. 1991 Sep;19(1):15-21. doi: 10.1007/BF01975200.

Abstract

In this study, patients with operable breast cancer T2 or T3, treated by mastectomy + axillary dissection and with invaded axillary nodes (N+), were randomized to receive either: 1) postoperative locoregional and pelvic radiotherapy (RX) and Poly(A).Poly(U) (AU), 60 mg IV once a week for 6 weeks, or 2) CMF (cyclophosphamide 100 mg/sqm P.O. on days 1-14, methotrexate 40 mg/sqm IV on day 1 and 8, fluorouracil 600 mg/sqm IV on day 1 and 8; monthly cycle, for 6 months. Between March 1982 and December 1985, 517 patients were enrolled, 257 of whom were treated by RX + AU and 260 with CMF. The main clinical, pathological and prognostic characteristics were equally distributed in the two groups. The present analysis was conducted after a mean follow-up of 69 months (S.D. = 13). There was no significant difference in overall survival (OS) between the two groups (test adjusted by center and menopausal status); the five-year OS rate was 74% in the RXAU group and 77% in the CMF group. Relapse-free survival (RFS) was significantly higher (p = 0.05) in the RXAU group compared to the MCF group; the five-year RFS rates were 57% and 46% in the two groups respectively. This short, well-tolerated combined RXAU treatment appears to be as efficient as CMF and might offer an alternative to chemo- or hormonotherapy, in case of contraindications to these treatments.

摘要

在本研究中,患有可手术切除的T2或T3期乳腺癌、接受乳房切除术+腋窝淋巴结清扫且腋窝淋巴结受累(N+)的患者被随机分为两组,分别接受:1)术后局部和盆腔放疗(RX)及聚肌苷酸-聚胞苷酸(Poly(A).Poly(U),简称AU),静脉注射60mg,每周1次,共6周;或2)CMF方案(环磷酰胺100mg/m²,口服,第1 - 14天;甲氨蝶呤40mg/m²,静脉注射,第1天和第8天;氟尿嘧啶600mg/m²,静脉注射,第1天和第8天;每月1个周期,共6个月)。1982年3月至1985年12月期间,共纳入517例患者,其中257例接受RX + AU治疗,260例接受CMF治疗。两组患者的主要临床、病理和预后特征分布均衡。本次分析是在平均随访69个月(标准差 = 13)后进行的。两组患者的总生存期(OS)无显著差异(经中心和绝经状态调整后的检验);RX + AU组的五年总生存率为74%,CMF组为77%。无复发生存期(RFS)方面,RX + AU组显著高于CMF组(p = 0.05);两组的五年无复发生存率分别为57%和46%。这种简短且耐受性良好的联合RX + AU治疗似乎与CMF方案同样有效,并且在这些治疗存在禁忌证的情况下,可能为化疗或激素治疗提供一种替代方案。

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