Wang Li-Ze, Ouyang Tao, Wang Tian-Feng, Xie Yun-Tao, Fan Zhao-Qing, Fan Tie, Lin Ben-Yao, Li Jin-Feng
Breast Cancer Center, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing 100142, China.
Zhonghua Zhong Liu Za Zhi. 2012 Feb;34(2):143-6. doi: 10.3760/cma.j.issn.0253-3766.2012.02.014.
To evaluate the effect of anthracycline pirarubicin-based regimen in association with different ways of fluorouracil (5-Fu) as neoadjuvant and adjuvant chemotherapy for primary breast cancer.
Two hundred and eighty-nine primary breast cancer patients who were to be operated, two to eight cycles of pirarubicin in association with cyclophosphamide and 5-Fu (CTF or CTFci regimen) were given before operation. The pathological response rate, effect and its relation with the infusion routes of 5-Fu were analyzed.
The overall pathological complete remission (pCR) rate was 28.4%. The median follow-up period was 39 months. The 5-year DFS was 87.6% (95% CI:82.1% to 92.7%), 5-year DDFS was 89.9% (95% CI:84.0% to 95.8%), and overall survival was 99.6%. CTFci (5-Fu, continuous infusion) regimen was superior to CTF regimen in pCR rates (32.3% vs. 20.2%, P = 0.037), and 5-year DDFS were 92.9% and 80.1%, respectively (P = 0.015). The pCR group was superior to non-pCR group in 5-year DDFS (92.4% vs. 85.6%, P = 0. 033). The pCR rate of patients with ER/PR-positive tumor was significantly lower than those of ER/PR-negative (P = 0.004). The 5-year DDFS rates of HER-2 (+) and HER-2(-) groups were 75.0% and 91.9%, respectively (P = 0.043). In the ER/PR-positve group, the 5-year DDFS of CTFci regimen was superior to those of CTF regimen, 91.4% vs. 81.4% (P = 0.047).
CTF/CTFci regimen as neoadjuvant and adjuvant chemotherapy is effective for primary breast cancer. CTFci regimen is superior to CTF regimen in pathological complete response rate and 5-year DDFS. CTFci regimen may do better to ER/PR (+) patients' benefits compared with CTF regimen.
评估以蒽环类药物吡柔比星为基础的方案联合不同给药方式的氟尿嘧啶（5-Fu）作为原发性乳腺癌新辅助化疗和辅助化疗的效果。
289例拟行手术的原发性乳腺癌患者，术前给予2至8个周期的吡柔比星联合环磷酰胺及5-Fu（CTF或CTFci方案）。分析病理缓解率、疗效及其与5-Fu输注途径的关系。
总体病理完全缓解（pCR）率为28.4%。中位随访期为39个月。5年无病生存率（DFS）为87.6%（95%CI：82.1%至92.7%），5年远处无病生存率（DDFS）为89.9%（95%CI：84.0%至95.8%），总生存率为99.6%。CTFci（5-Fu持续输注）方案在pCR率方面优于CTF方案（32.3%对20.2%，P = 0.037），5年DDFS分别为92.9%和80.1%（P = 0.015）。pCR组在5年DDFS方面优于非pCR组（92.4%对85.6%，P = 0.033）。雌激素受体（ER）/孕激素受体（PR）阳性肿瘤患者的pCR率显著低于ER/PR阴性患者（P = 0.004）。人表皮生长因子受体2（HER-2）（+）组和HER-2（-）组的5年DDFS率分别为75.0%和91.9%（P = 0.043）。在ER/PR阳性组中，CTFci方案的5年DDFS优于CTF方案，分别为91.4%和81.4%（P = 0.047）。
CTF/CTFci方案作为新辅助化疗和辅助化疗对原发性乳腺癌有效。CTFci方案在病理完全缓解率和5年DDFS方面优于CTF方案。与CTF方案相比，CTFci方案对ER/PR（+）患者可能更有益。
