Padmanabhan N, Howell A, Rubens R D
Lancet. 1986 Aug 23;2(8504):411-4. doi: 10.1016/s0140-6736(86)92131-8.
The relation between tumour oestrogen and progesterone receptor status, menstrual status, relapse-free survival, and overall survival was analysed in 411 patients with early breast cancer randomised to receive either postoperative adjuvant chemotherapy with cyclophosphamide, methotrexate, and fluorouracil (CMF) or no additional treatment (control). Prolongation of time to recurrence and survival was seen predominantly in premenopausal patients; these effects were seen only with tumours positive for steroid receptors, particularly progesterone. Chemotherapy led to permanent amenorrhoea in 61% of premenopausal patients. The therapeutic effects of chemotherapy were seen only when CMF induced permanent amenorrhoea in premenopausal patients. These findings support the hypothesis that the effect of adjuvant chemotherapy in early breast cancer may be mediated by ovarian suppression.
对411例早期乳腺癌患者进行了分析，这些患者被随机分为两组，一组接受环磷酰胺、甲氨蝶呤和氟尿嘧啶（CMF）术后辅助化疗，另一组不接受额外治疗（对照组），分析了肿瘤雌激素和孕激素受体状态、月经状态、无复发生存率和总生存率之间的关系。复发时间和生存期的延长主要见于绝经前患者；这些效应仅在类固醇受体阳性的肿瘤中出现，尤其是孕激素受体。化疗导致61%的绝经前患者永久性闭经。仅当CMF诱导绝经前患者永久性闭经时，才观察到化疗的治疗效果。这些发现支持了以下假设，即早期乳腺癌辅助化疗的效果可能是由卵巢抑制介导的。
