Garewal H S
Section of Hematology-Oncology, University of Arizona Health Sciences Center, Tucson 85724.
Semin Oncol. 1988 Jun;15(3 Suppl 4):74-9.
Mitomycin C is a chemotherapeutic agent active against breast cancer. Because one of its potential toxicities is prolonged myelosuppression, it is not generally used in first-line chemotherapy regimens. However, several mitomycin C-containing combinations are effective in the salvage therapy of patients that have failed to respond to previous regimens. The choice of a salvage combination depends on the previous treatment received by an individual patient. Patients failing regimens based on CMF (cyclophosphamide, methotrexate, 5-fluorouracil [5-FU]) should be treated with combinations incorporating drugs not included in CMF. Active agents in this setting include mitomycin C, doxorubicin, and vinca alkaloids (usually vinblastine). Patients treated with combinations based on doxorubicin and cyclophosphamide (AC) are frequently administered a CMF-type regimen after a cumulative dose of doxorubicin has been reached. Therefore, they have often received doxorubicin, cyclophosphamide, methotrexate, and 5-FU. Salvage chemotherapy for failing patients in this setting is generally based on mitomycin C and/or vinblastine. Selection of a chemotherapeutic regimen for breast cancer must take into account the palliative nature of chemotherapy in this disease. Consequently, effective combinations that can be administered with minimal disruption of a patient's life-style are preferred.
丝裂霉素C是一种对乳腺癌有效的化疗药物。由于其潜在毒性之一是长期骨髓抑制，它一般不用于一线化疗方案。然而，几种含丝裂霉素C的联合用药方案对先前治疗方案无效的患者的挽救治疗有效。挽救联合用药方案的选择取决于个体患者先前接受的治疗。对基于CMF（环磷酰胺、甲氨蝶呤、5-氟尿嘧啶[5-FU]）方案治疗失败的患者，应采用包含CMF中未包含药物的联合用药方案进行治疗。这种情况下的有效药物包括丝裂霉素C、多柔比星和长春花生物碱（通常为长春碱）。接受基于多柔比星和环磷酰胺（AC）联合用药方案治疗的患者，在达到多柔比星累积剂量后，常给予CMF类方案。因此，他们常接受过多柔比星、环磷酰胺、甲氨蝶呤和5-FU治疗。这种情况下治疗失败患者的挽救化疗通常基于丝裂霉素C和/或长春碱。乳腺癌化疗方案的选择必须考虑到该病化疗的姑息性质。因此，首选能在对患者生活方式干扰最小的情况下给药的有效联合用药方案。
