Rubens R D, Bartelink H, Engelsman E, Hayward J L, Rotmensz N, Sylvester R, van der Schueren E, Papadiamantis J, Vassilaros S D, Wildiers J
ICRF Clinical Oncology Unit, Guy's Hospital, London, U.K.
Eur J Cancer Clin Oncol. 1989 Apr;25(4):667-78. doi: 10.1016/0277-5379(89)90203-4.
Patients with locally advanced carcinoma of the breast were randomized to receive either radiotherapy alone, radiotherapy + endocrine therapy, radiotherapy + chemotherapy or radiotherapy + endocrine therapy + chemotherapy. In 363 evaluable patients, time to first progression was delayed significantly by both endocrine treatment and chemotherapy, the greatest effect being achieved by the combination of endocrine treatment and chemotherapy. This effect was almost entirely due to a major effect of systemic treatment on time to loco-regional progression, for which the result is highly significant, rather than time to distant metastasis in which only a non-significant trend was observed. For survival, a trend was seen in favour of the combination of hormone treatment and chemotherapy, but this effect did not achieve statistical significance. This trial suggests that current endocrine and cytotoxic treatments are only of marginal value in improving the prognosis in locally advanced breast cancer.
局部晚期乳腺癌患者被随机分为四组，分别接受单纯放疗、放疗+内分泌治疗、放疗+化疗或放疗+内分泌治疗+化疗。在363例可评估患者中，内分泌治疗和化疗均显著延迟了首次进展时间，内分泌治疗与化疗联合应用的效果最为显著。这种效果几乎完全归因于全身治疗对局部区域进展时间的显著影响，而对远处转移时间仅观察到不显著的趋势。对于生存率，激素治疗与化疗联合应用显示出一定趋势，但未达到统计学显著性。该试验表明，目前的内分泌和细胞毒性治疗在改善局部晚期乳腺癌预后方面仅具有边际价值。
