Nakamura Y, Kawaguchi M, Hata A, Watanabe H, Ueki Y, Oribe T, Koba F, Takamuku K
Dept. of Surgery, Oita Prefectural Hospital.
Gan To Kagaku Ryoho. 1989 Feb;16(2):243-50.
Sixty-three evaluable patients with metastatic and stage IV breast cancer who had not previously undergone chemo-endocrine therapy were treated with a combination chemoendocrine therapy regimen consisting of cyclophosphamide 100 mg p.o. every day, adriamycin 10 mg i.v. on day 1 to 5, prednisolone 10 mg or 20 mg (20 mg was given on day 1 to 5) p.o. every day, and tamoxifen 20 mg p.o. every day. Adriamycin on day 1 to 5 was repeated three times every two weeks. After a total dose of 150 mg of adriamycin, the patients were changed to maintenance therapy consisting of cyclophosphamide 100 mg p.o., prednisolone 10 mg p.o. and tamoxifen 20 mg p.o. every day. After 72 months of the treatment there were 61 patients good for evaluation, 13 patients achieved a complete response (21.3%) with a median survival of 30.5 months and 18 patients had a partial response (29.5%) with a median survival of 21.0 months, and 30 patients failed to respond (49.2%) with a median survival of 8.5 months. There was a significant difference in survival time between responders (CR + PR) and non-responders (NC + PD) (p less than 0.001). Responses by site were seen in lung 10/18 (55.6%), liver 3/6 (50.0%), brain 2/4 (50.0%), bone 6/17 (35.3%) and soft tissue 14/24 (56.3%). A Satisfactory response for brain and liver metastasis, which are usually viewed as a sign of grim prognosis, was obtained similar to other sites of metastasis. Retreatment with CAPT, which was attempted in patients with secondary brain metastasis who responded to CAPT for initial brain metastasis, was uniformly effective. High ration of androgen to corticosteroid, positive estrogen receptors, long disease-free survival (over two years), premenopausal, high Broca' index (above 110) resulted from the chemo-endocrine therapy regimen CAPT. Toxicity was minimal and consisted of nausea, vomiting, alopecia and leucopenia.
63例未曾接受过化疗-内分泌治疗的转移性和IV期乳腺癌可评估患者，接受了一种联合化疗-内分泌治疗方案，该方案包括每天口服环磷酰胺100mg、第1至5天静脉注射阿霉素10mg、每天口服泼尼松龙10mg或20mg（第1至5天给予20mg）以及每天口服他莫昔芬20mg。第1至5天的阿霉素每两周重复3次。在阿霉素总剂量达到150mg后，患者改为维持治疗，包括每天口服环磷酰胺100mg、泼尼松龙10mg和他莫昔芬20mg。治疗72个月后，有61例患者可供评估，13例患者达到完全缓解（21.3%），中位生存期为30.5个月，18例患者部分缓解（29.5%），中位生存期为21.0个月，30例患者无反应（49.2%），中位生存期为8.5个月。反应者（CR+PR）和无反应者（NC+PD）之间的生存时间存在显著差异（p小于0.001）。按转移部位的反应情况为：肺10/18（55.6%）、肝3/6（50.0%）、脑2/4（50.0%）、骨6/17（35.3%）和软组织14/24（56.3%）。对于通常被视为预后不良标志的脑和肝转移，获得了与其他转移部位相似的满意反应。对初始脑转移对CAPT有反应的继发性脑转移患者尝试进行CAPT再治疗，均有效。化疗-内分泌治疗方案CAPT导致雄激素与皮质类固醇比例高、雌激素受体阳性、无病生存期长（超过两年）、绝经前、布罗卡指数高（高于110）。毒性极小，包括恶心、呕吐、脱发和白细胞减少。
