Stephens F O
Department of Surgery, University of Sydney, NSW, Australia.
Cancer. 1990 Aug 15;66(4):645-50. doi: 10.1002/1097-0142(19900815)66:4<645::aid-cncr2820660407>3.0.co;2-w.
Five-year results are reported on 27 patients with locally advanced breast cancer treated by intraarterial induction chemotherapy followed by radiotherapy and/or surgery with subsequent adjuvant chemotherapy. The cyclic infusion chemotherapy regimen was given over 3 to 6 weeks using Adriamycin (doxorubicin), 5-fluorouracil (5-FU), vincristine, and methotrexate in daily rotation. Regional and systemic side effects were minimal and temporary except in two patients in whom some skin discoloration has remained. Local tumor control and 5-year cures depended on two important factors: whether follow-up mastectomy was used after initial local tumor regression; and whether the carcinoma was classified as "inflammatory" with pathologic evidence of tumor invasion of dermal lymphatics. Of 16 patients with noninflammatory carcinoma treated by chemotherapy, radiotherapy, and mastectomy local tumor eradication was achieved in 15 and 5-year apparent cure in 11. Of six patients with noninflammatory carcinoma treated with chemotherapy and radiotherapy but no mastectomy 5-year local control was achieved in only three and 5-year apparent cure in three. Of five patients with pathologic inflammatory carcinoma local tumor control was achieved in only one and only this one patient has been a 5-year survivor apparently tumor-free.
报告了27例局部晚期乳腺癌患者的五年结果，这些患者接受了动脉内诱导化疗，随后进行放疗和/或手术，并进行辅助化疗。采用阿霉素（多柔比星）、5-氟尿嘧啶（5-FU）、长春新碱和甲氨蝶呤每日轮流给药，在3至6周内进行循环灌注化疗。除两名患者仍有一些皮肤变色外，局部和全身副作用轻微且为暂时性。局部肿瘤控制和五年治愈率取决于两个重要因素：初始局部肿瘤消退后是否进行后续乳房切除术；以及癌症是否被归类为“炎性”，并有肿瘤侵犯真皮淋巴管的病理证据。在16例接受化疗、放疗和乳房切除术的非炎性癌患者中，15例实现了局部肿瘤根除，11例实现了五年表观治愈。在6例接受化疗和放疗但未进行乳房切除术的非炎性癌患者中，只有3例实现了五年局部控制，3例实现了五年表观治愈。在5例病理炎性癌患者中，只有1例实现了局部肿瘤控制，只有这名患者成为了五年幸存者，显然无肿瘤。
