Hartlapp J H
Onkologie. 1986 Aug;9 Suppl 1:3-7. doi: 10.1159/000216052.
Patients with metastasized breast cancer are incurable. Remissions with longer survival can be induced by chemotherapy in 50 to 80%, with 10 to 20% complete remissions, however, recurrence is unavoidable. Therefore the strategy of therapy in breast cancer must include two aspects: first prolongation of overall survival by multiple remissions with regimes that are not cross-resistant and secondly conservation of quality of life by minimization of therapy conditioned side-effects. Epirubicin, the new anthracycline derivate and analogue of doxorubicin (probably the most active chemotherapeutic agent against breast cancer) exhibits the same high activity but lower side-effects compared with the parent compound. Complete and partial remissions in 33% of 313 breast cancer patients could be achieved with epirubicin. In three other studies the efficacy and side-effects of epirubicin were compared with the established drug doxorubicin. The remission rate was nearly the same but the side-effects such as nausea, vomiting, stomatitis, bone marrow toxicity and congestive heart failure were lower. Five different studies with epirubicin in combination with other cytostatics have shown comparable results as adriamycin combinations. In a randomized multicenter study, 520 patients were treated with epirubicin or doxorubicin in combination with cyclophosphamide and fluorouracil. The remission rates were 52 vs. 54%, respectively, but the toxicity of the epirubicin combination group was significantly lower.
转移性乳腺癌患者无法治愈。化疗可使50%至80%的患者获得生存期延长的缓解，其中10%至20%为完全缓解，然而复发不可避免。因此，乳腺癌的治疗策略必须包括两个方面：一是通过使用无交叉耐药的方案实现多次缓解来延长总生存期，二是通过尽量减少治疗引起的副作用来保持生活质量。表柔比星是一种新的蒽环类衍生物，也是阿霉素（可能是治疗乳腺癌最有效的化疗药物）的类似物，与母体化合物相比，它具有相同的高活性，但副作用较小。使用表柔比星可使313例乳腺癌患者中的33%实现完全缓解和部分缓解。在其他三项研究中，将表柔比星的疗效和副作用与已确立的药物阿霉素进行了比较。缓解率几乎相同，但恶心、呕吐、口腔炎、骨髓毒性和充血性心力衰竭等副作用较低。五项关于表柔比星与其他细胞抑制剂联合使用的不同研究显示了与阿霉素联合使用相当的结果。在一项随机多中心研究中，520例患者接受了表柔比星或阿霉素联合环磷酰胺和氟尿嘧啶的治疗。缓解率分别为52%和54%，但表柔比星联合治疗组的毒性明显较低。
