Yap H Y, Hortobagyi G N, Blumenschein G R, Tashima C K, Buzdar A U, Krutchik A N, Benjamin R S, Gutterman J U, Bodey G P
J Surg Oncol. 1979 Dec;12(4):333-41. doi: 10.1002/jso.2930120407.
Ninety-eight premenopausal patients with stage IV breast cancer were treated with chemoimmunotherapy alone, or with combination oophorectomy-chemoimmunotherapy either simultaneously (chemoimmunotherapy within four weeks of oophorectomy) or sequentially (delayed chemoimmunotherapy until evidence of progressive disease or no response to oophorectomy). The chemoimmunotherapy consisted of a three-drug combination of Adriamycin, cyclophosphamide, and 5-fluorouracil or Ftorafur; immunotherapy consisted of either oral levamisole, BCG by scarification, or a combination of both. Forty patients underwent simultaneous oophorectomy-chemoimmunotherapy, with a response rate of 85% and a median duration of response of 25 months. Response rate of 69% and a median duration of response of 16.6 months was observed with the 29 patients who received sequential oophorectomy-chemoimmunotherapy. Another 29 patients were treated with chemoimmunotherapy alone and achieved a response rate of 87% and a median duration of response of 11.8 months. Though there were no significant differences in the response rate, patients treated with chemoimmunotherapy alone had a significantly shorter median duration of response (P less than 0.05). This would suggest that oophorectomy in combination with chemoimmunotherapy is the most favorable treatment modality for premenopausal patients with advanced metastatic breast cancer.
98例IV期乳腺癌绝经前患者接受单纯化疗免疫治疗，或同时接受卵巢切除术-化疗免疫联合治疗（卵巢切除术后4周内进行化疗免疫治疗）或序贯治疗（延迟化疗免疫治疗直至出现疾病进展证据或对卵巢切除术无反应）。化疗免疫治疗由阿霉素、环磷酰胺和5-氟尿嘧啶或喃氟啶三种药物联合组成；免疫治疗包括口服左旋咪唑、划痕接种卡介苗或两者联合。40例患者接受了同时进行的卵巢切除术-化疗免疫治疗，有效率为85%，中位缓解持续时间为25个月。29例接受序贯卵巢切除术-化疗免疫治疗的患者有效率为69%，中位缓解持续时间为16.6个月。另外29例患者接受单纯化疗免疫治疗，有效率为87%，中位缓解持续时间为11.8个月。尽管有效率无显著差异，但单纯化疗免疫治疗的患者中位缓解持续时间明显较短（P小于0.05）。这表明卵巢切除术联合化疗免疫治疗是绝经前晚期转移性乳腺癌患者最有利的治疗方式。
