Ragaz J, Baird R, Rebbeck P, Goldie J, Coldman A, Spinelli J
Cancer. 1985 Aug 15;56(4):719-24. doi: 10.1002/1097-0142(19850815)56:4<719::aid-cncr2820560403>3.0.co;2-w.
Despite recent developments in the treatment of breast cancer, metastatic breast cancer remains an incurable disease. Postoperative adjuvant treatment may improve the survival of a subgroup of node positive, Stage II breast cancer patients, but the proportion of failures is still high. Preoperative adjuvant chemotherapy, an example of a new approach in scheduling of available agents, is based on sound theoretical and experimental principles. In this report, the authors summarize the background data on the rationale for preoperative adjuvant chemotherapy and present preliminary results of this study in which preoperative treatment starting with one course of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) was given to newly diagnosed patients with breast cancer. Analysis of the first 43 patients given such treatment has shown that the side effects were comparable to those seen in patients treated with conventional postoperative chemotherapy, and that the delay time between diagnosis and starting chemotherapy has been substantially reduced compared to the historic group of patients. Additional aspects of this study include the introduction of fine-needle aspiration as the only diagnostic method for obtaining the tissue diagnosis of breast cancer, as well as a more intensive interaction between the surgeons from private practice and the oncology institute.
尽管乳腺癌治疗方面最近有了进展，但转移性乳腺癌仍然是一种无法治愈的疾病。术后辅助治疗可能会提高一部分淋巴结阳性的II期乳腺癌患者的生存率，但治疗失败的比例仍然很高。术前辅助化疗是现有药物给药方案中的一种新方法，它基于合理的理论和实验原则。在本报告中，作者总结了术前辅助化疗基本原理的背景数据，并展示了本研究的初步结果，该研究对新诊断的乳腺癌患者先给予一个疗程的环磷酰胺、甲氨蝶呤和5-氟尿嘧啶（CMF）进行术前治疗。对首批接受该治疗的43例患者的分析表明，其副作用与接受传统术后化疗的患者相当，并且与历史患者组相比，诊断与开始化疗之间的延迟时间大幅缩短。本研究的其他方面包括引入细针穿刺作为获取乳腺癌组织诊断的唯一诊断方法，以及私人执业外科医生与肿瘤研究所之间更密切的互动。
