Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Cancer Res Treat. 2005 Feb;37(1):24-30. doi: 10.4143/crt.2005.37.1.24. Epub 2005 Feb 28.
The benefit of high-dose chemotherapy (HDC) for metastatic breast cancer (MBC) is controversial. We evaluated the efficacy and safety of HDC with cyclophosphamide, thiotepa, and carboplatin (CTCb) followed by autologous stem-cell transplantation (ASCT) for MBC patients.
From September 1994 to December 1999, 23 MBC patients were enrolled. All the patients received 2 to 10 cycles of induction chemotherapy. Before transplantation, 12 patients were in complete response (CR), nine were in partial response (PR), and two had progressive disease (PD). The HDC regimen consisted of cyclophosphamide 1,500 mg/m(2)/day, thiotepa 125 mg/m(2)/day and carboplatin 200 mg/m(2)/day intravenously for 4 consecutive days.
After ASCT, 13 patients (56%) had a CR, five (22%) had a PR, three (13%) had no change, while two (9%) showed a PD. Seventeen patients relapsed or progressed during the median follow-up of 78 months. The median progression-free survival (PFS) time was 11 months and the median overall survival (OS) time was 23 months. The 5-year PFS and OS rates were 22% and 25%, respectively. On the multivariate analyses, less than 4 involved lymph nodes was predictive of a better PFS and OS.
HDC with CTCb for MBC has acceptable toxicity; however, this treatment does not show a survival benefit.
高剂量化疗（HDC）治疗转移性乳腺癌（MBC）的益处存在争议。我们评估了环磷酰胺、噻替哌和卡铂（CTCb）联合大剂量化疗后自体造血干细胞移植（ASCT）治疗 MBC 患者的疗效和安全性。
1994 年 9 月至 1999 年 12 月，共纳入 23 例 MBC 患者。所有患者均接受了 2 至 10 个周期的诱导化疗。在移植前，12 例患者达到完全缓解（CR），9 例部分缓解（PR），2 例疾病进展（PD）。HDC 方案包括环磷酰胺 1500mg/m²/天、噻替哌 125mg/m²/天和卡铂 200mg/m²/天，静脉输注 4 天。
ASCT 后，13 例（56%）患者达到 CR，5 例（22%）患者达到 PR，3 例（13%）患者无变化，2 例（9%）患者出现 PD。在中位随访 78 个月期间，17 例患者复发或进展。中位无进展生存期（PFS）为 11 个月，中位总生存期（OS）为 23 个月。5 年 PFS 和 OS 率分别为 22%和 25%。多因素分析显示，淋巴结受累少于 4 个与更好的 PFS 和 OS 相关。
CTCb 联合 HDC 治疗 MBC 的毒性可接受，但该治疗并不能带来生存获益。
