Brunner K W
Schweiz Med Wochenschr. 1978 Sep 2;108(35):1338-50.
Several decisive developments have emerged during the past few years in the hormonal treatment and chemotherapy receptors should make for a more selective and successful application of hormone therapy. In the field of chemotherapy, highly active substances have been developed. Two groups of routine treatment may be defined: the first employs combinations of cytoxan, methotrexate, 5-fluorouracil and prednisone, and the other, combinations of these agents with the highly active adriamycin. With these combinations, remissions lasting an average of over one year, with significantly prolonged survival, can be achieved in about two thirds of patients. It remains uncertain whether initial addition of hormone treatment to the chemotherapy is of definite advantage. Modern chemotherapy appears to have been especially beneficial in altering the course in patients with poor prognosis. The newest development is the use of chemotherapy postoperatively, i.e. so-called adjuvant chemotherapy. For the present this should only be done within controlled studies and in patients with histologically proven axillary lymph node metastases.
在过去几年中,激素治疗和化疗领域出现了几个决定性的进展,这些进展应该会使激素治疗的应用更加有选择性且更为成功。在化疗领域,已经研发出了高活性物质。可以确定两类常规治疗方法:第一种采用环磷酰胺、甲氨蝶呤、5-氟尿嘧啶和泼尼松的联合用药,另一种是这些药物与高活性阿霉素的联合用药。通过这些联合用药,大约三分之二的患者能够实现平均持续超过一年的缓解期,并且生存期显著延长。化疗初始阶段加用激素治疗是否具有明确优势仍不确定。现代化疗似乎对改变预后不良患者的病程特别有益。最新进展是术后使用化疗,即所谓的辅助化疗。目前,这只应在对照研究中以及组织学证实有腋窝淋巴结转移的患者中进行。