Guenzi M, Scarpati D, Corvò R, Sanguineti G, Gardin G, Conte P F, Vitale V
Istituto Nazionale per la Ricerca sul Cancro, Genova.
Radiol Med. 1990 May;79(5):534-8.
From September 1983 to March 1988, 57 patients with locally-advanced breast cancer were treated at the Istituto Nazionale per la Ricerca sul Cancro in Genoa, Italy. All patients received 3 cycles of induction chemotherapy with estrogenic recruitment before surgery (diethylstilbesterol-DES-FAC) and 6 additional cycles of chemotherapy (3 DES FAC alternating with 3 DES CMF) after surgery. Stage III A (15) patients reached 86% local relapse-free survival (LRFS), 68% disease-free survival (DFS), and 85% overall survival (OS). Stage III B (42) patients had 82% LRFS, 59% DFS, and 33% OS at 5 years. The first site of relapse was locoregional in 35% of the patients: 19% chest wall recurrence, 3.5% chest wall and lymph nodes, and 7% regional nodes; 5% of the cases presented synchronous local and systemic recurrence; distant metastases represented 21% of the initial relapse rate. This therapy appears to improve the prognosis of III A patients more than that of III B patients. Unsatisfactory results were obtained in inflammatory cancer, with 54% of local recurrences. The present study indicates that radiotherapy is necessary to improve local control and to increase DFS in inflammatory breast cancer. Moreover, the use of radiation therapy also improves the results in III A and III B patients.
1983年9月至1988年3月，意大利热那亚国家癌症研究所对57例局部晚期乳腺癌患者进行了治疗。所有患者在手术前接受3个周期的雌激素募集诱导化疗（己烯雌酚-DES-FAC），术后再接受6个周期的化疗（3个DES FAC与3个DES CMF交替）。ⅢA期（15例）患者的局部无复发生存率（LRFS）达到86%，无病生存率（DFS）达到68%，总生存率（OS）达到85%。ⅢB期（42例）患者5年时的LRFS为82%，DFS为59%，OS为33%。35%的患者复发的首个部位是局部区域：19%为胸壁复发，3.5%为胸壁和淋巴结复发，7%为区域淋巴结复发；5%的病例出现同步局部和全身复发；远处转移占初始复发率的21%。这种治疗似乎对ⅢA期患者预后的改善比对ⅢB期患者更明显。炎性癌的治疗效果不理想，局部复发率为54%。本研究表明，放疗对于改善炎性乳腺癌的局部控制和提高DFS是必要的。此外，放疗的使用也改善了ⅢA期和ⅢB期患者的治疗结果。
