Hryniuk W, Levine M N
J Clin Oncol. 1986 Aug;4(8):1162-70. doi: 10.1200/JCO.1986.4.8.1162.
We have analyzed the relationship between dose intensity of cyclophosphamide, methotrexate, and fluorouracil (CMF)-containing adjuvant chemotherapy of stage II breast cancer and 3-year relapse-free survival. Studies using only one or two drugs of CMF or melphalan instead of cyclophosphamide were included in the analysis by using simple techniques developed for this purpose. There was a clear-cut relationship between relapse-free survival and dose intensity in trials containing all four prognostic groups: less than 50 years, one to three and more than three positive nodes; and greater than or equal to 50 years, one to three and more than three positive nodes (P less than 10(-5)). Relapse-free survival also correlated with dose intensity for each of the four prognostic groups analyzed separately (P less than .005). Dose intensity was an independently significant correlate of relapse-free survival in multivariate analysis (P less than 10(-5)). This is a retrospective study, and the hypothesis that dose intensity contributes to outcome independently of other variables should be tested prospectively. Methods of increasing dose intensity also require testing in randomized trials before they can be applied to routine clinical practice.
我们分析了环磷酰胺、甲氨蝶呤和氟尿嘧啶（CMF）辅助化疗的剂量强度与II期乳腺癌3年无复发生存率之间的关系。使用为此开发的简单技术，将仅使用CMF中的一种或两种药物或使用美法仑替代环磷酰胺的研究纳入分析。在包含所有四个预后组的试验中，无复发生存率与剂量强度之间存在明确的关系：年龄小于50岁，1至3个及超过3个阳性淋巴结；年龄大于或等于50岁，1至3个及超过3个阳性淋巴结（P小于10^(-5)）。对分别分析的四个预后组中的每一组，无复发生存率也与剂量强度相关（P小于0.005）。在多变量分析中，剂量强度是无复发生存率的独立显著相关因素（P小于10^(-5)）。这是一项回顾性研究，剂量强度独立于其他变量对结果有影响这一假设应进行前瞻性检验。在可应用于常规临床实践之前，增加剂量强度的方法也需要在随机试验中进行检验。
