Vincent M D, Powles T J, Coombes R C, McElwain T J
Royal Marsden Hospital, Institute of Cancer Research, Sutton, Surrey, England.
Cancer Chemother Pharmacol. 1988;21(3):255-60. doi: 10.1007/BF00262781.
Fifteen patients with advanced breast cancer who had achieved either a good partial or a complete response to conventional chemotherapy were selected to receive intensification treatment with high-dose melphalan 140-200 mg/m2 (HDM). All patients received autologous bone marrow rescue. All patients experienced marked haematological toxicity, and most experienced moderate or mild gastrointestinal side effects. There were three treatment-related deaths. Of twelve assessable patients eleven have relapsed; median time to relapse after HDM is 7 months. Nine of these eleven have died from recurrent breast cancer. Of the three patients remaining alive, only one is disease-free, at 18 months after HDM. Analysis of the pattern of metastatic relapse suggests that recurrence was due to failure of HDM to eradicate residual disease in the patient, rather than reinfusion of viable tumour cells. Treatment intensification with HDM has not succeeded in prolonging survival in patients already in good remission.
选择15例对传统化疗已取得良好部分缓解或完全缓解的晚期乳腺癌患者，接受剂量为140 - 200mg/m²的大剂量美法仑（HDM）强化治疗。所有患者均接受自体骨髓解救。所有患者均出现明显的血液学毒性，多数患者经历了中度或轻度胃肠道副作用。有3例与治疗相关的死亡。在12例可评估的患者中，11例复发；HDM治疗后至复发的中位时间为7个月。这11例患者中有9例死于复发性乳腺癌。在 remaining alive（原文此处有误，推测应为remaining alive）的3例患者中，只有1例在HDM治疗后18个月时无疾病复发。对转移复发模式的分析表明，复发是由于HDM未能根除患者体内的残留疾病，而非再输注存活的肿瘤细胞。对于已经处于良好缓解状态的患者，用HDM进行治疗强化未能成功延长生存期。
