Carbone P P, Bauer M, Band P, Tormey D
Cancer. 1977 Jun;39(6 Suppl):2916-22. doi: 10.1002/1097-0142(197706)39:6<2916::aid-cncr2820390678>3.0.co;2-z.
Chemotherapy once relegated to end stage patients has markedly improved with the use of combinations. Response rates with single agents have improved from 15 to 35%, to 50 to 70%, using combinations with an increase in complete response rates to about 25%. A series of four studies completed by the Eastern Cooperative Oncology Group over the past eight years typifies the improvement in response rates achieved by combinations as compared to single agents. Survival gain can be demonstrated for responders vs non-responders; however with current combinations, there is an apparent plateau in response rates (55 to 60%), durations of response (eight months) and survival for responders (18-22 months) as compared to survival of non-responders (six to eight months). Further improvement in response rates may occur by searching for new agents, combining hormonal and immunostimulation with chemotherapy or by sequencing non-crossresistant combinations. However, since most patients with breast cancer present with local or regional disease but go on to die of disseminated cancer, major improvements in survival are most likely to occur by treating this neoplasm as a systemic disease through cobmining effective local therapy with systemic treatments.
曾经仅用于晚期患者的化疗，通过联合用药有了显著改善。单药治疗的缓解率已从15%提高到35%，联合用药时则提高到50%至70%，完全缓解率提高到约25%。东部肿瘤协作组在过去八年完成的一系列四项研究，体现了联合用药与单药治疗相比在缓解率方面的改善。 responders与non-responders相比可证明有生存获益；然而，与non-responders的生存时间（6至8个月）相比，目前联合用药的缓解率（55%至60%）、缓解持续时间（8个月）以及responders的生存时间（18至22个月）似乎已达到平台期。通过寻找新药物、将激素和免疫刺激与化疗联合或采用非交叉耐药联合用药的序贯治疗，缓解率可能会进一步提高。然而，由于大多数乳腺癌患者初诊时为局部或区域病变，但最终死于播散性癌症，因此通过将有效的局部治疗与全身治疗相结合，把这种肿瘤作为一种全身性疾病来治疗，最有可能大幅提高生存率。 （注：原文中“responders”和“non-responders”未明确中文释义，保留英文以便理解原文语境）
