Ford J M, Panasci L, Leclerc Y, Margolese R
Department of Oncology, Jewish General Hospital, Montreal, Quebec, Canada.
Cancer Treat Rep. 1987 Oct;71(10):921-5.
To exploit possible different non-cross-resistant mechanisms of cytotoxicity, 25 patients with advanced breast cancer were given combination chemotherapy consisting of iv mitoxantrone (7 mg/m2) and doxorubicin (30 mg/m2) every 3-4 weeks. The patients had predominantly visceral disease and received a median of six (range, one to 12) cycles of therapy. There were no complete responders, but 13 patients (52%) achieved partial remission lasting a median of 8 months (range, 4-21+). Three patients (12%) had disease stabilization and nine (36%) had disease progression. Hematologic toxicity was generally mild, with median wbc count and platelet count nadirs of 1900/mm3 (range, 700-3100) and 160,000/mm3 (range, 49,000-406,000), respectively. One patient may have died from treatment-related sepsis (pneumonia), but lymphangitic lung disease was not excluded. Hair loss progressing to severe alopecia over several treatment cycles was relatively common, affecting seven of 16 evaluable patients (44%). Vomiting was mild or absent in 17 (71%) of 24 evaluable patients. Three of 15 patients in whom serial measurements of left ventricular ejection fraction were performed developed significant reductions compatible with anthracycline-induced cardiotoxicity. Two of these patients also had pericardial effusions and one developed congestive heart failure. In conclusion, mitoxantrone and doxorubicin is an active, well-tolerated drug combination for the treatment of advanced breast cancer but may have appreciable cardiotoxicity.
为探索细胞毒性可能存在的不同非交叉耐药机制，25例晚期乳腺癌患者接受了联合化疗，每3 - 4周静脉注射米托蒽醌（7mg/m²）和阿霉素（30mg/m²）。患者主要为内脏疾病，接受的中位治疗周期数为6个（范围1至12个）。无完全缓解者，但13例患者（52%）达到部分缓解，中位缓解持续时间为8个月（范围4至21 +个月）。3例患者（12%）病情稳定，9例患者（36%）病情进展。血液学毒性一般较轻，白细胞计数和血小板计数的中位最低点分别为1900/mm³（范围700至3100）和160,000/mm³（范围49,000至406,000）。1例患者可能死于治疗相关的败血症（肺炎），但未排除淋巴管炎型肺病。在几个治疗周期中脱发进展为严重脱发相对常见，16例可评估患者中有7例（44%）出现。24例可评估患者中有17例（71%）呕吐轻微或无呕吐。在15例进行左心室射血分数系列测量的患者中，有3例出现与蒽环类药物诱导的心脏毒性相符的显著降低。其中2例患者还伴有心包积液，1例发展为充血性心力衰竭。总之，米托蒽醌和阿霉素是治疗晚期乳腺癌的一种有效且耐受性良好的药物组合，但可能有明显的心脏毒性。
