Canellos G P, Devita V T, Gold G L, Chabner B A, Schein P S, Young R C
Br Med J. 1974 Feb 9;1(5901):218-20. doi: 10.1136/bmj.1.5901.218.
Twenty-five patients with advanced metastatic breast cancer were treated with the combination of methotrexate 60 mg/M(2) and 5-fluorouracil 700 mg/M(2) intravenously on the first and eighth days, and cyclophosphamide 100 mg/M(2) and prednisone 40 mg/M(2) by mouth daily for the first 14 days of a 28-day cycle. The patients had had no previous chemotherapy or extensive radiotherapy and all but two had not responded to hormonal therapy or endocrine ablation. The major metastatic lesions were: lung (12 patients), liver (four patients), bone (four patients), soft tissue (three patients), nodes (two patients). Seventeen of the 25 patients (68%) responded to treatment with seven complete remissions; these included patients suffering metastatic lesions in the lung, nodes, and soft tissue. The overall median duration of response was nine months (range 6-26 months). Toxicity was primarily haematological, but the group received an average of at least 75% of their calculated dose for each monthly cycle. Haematological toxicity was most pronounced in patients with liver dysfunction and bone marrow involvement. Out of eight nonresponders seven died, with a median survival of six months. Only six of 17 responders died, and the median survival in this group will exceed thirteen months. There was no correlation between the length of the metastasis-free interval after previous treatment and subsequent response to chemotherapy.
25例晚期转移性乳腺癌患者接受如下治疗：在28天周期的第1天和第8天，静脉注射甲氨蝶呤60mg/M²和5-氟尿嘧啶700mg/M²；在周期的前14天，每天口服环磷酰胺100mg/M²和泼尼松40mg/M²。这些患者既往未接受过化疗或广泛放疗，除2例患者外，其余患者均对激素治疗或内分泌消融无反应。主要转移病灶为：肺（12例）、肝（4例）、骨（4例）、软组织（3例）、淋巴结（2例）。25例患者中有17例（68%）对治疗有反应，7例完全缓解；其中包括有肺、淋巴结和软组织转移病灶的患者。总体缓解的中位持续时间为9个月（范围6 - 26个月）。毒性主要为血液学毒性，但该组患者每个月周期平均接受至少75%的计算剂量。血液学毒性在肝功能不全和骨髓受累的患者中最为明显。8例无反应者中有7例死亡，中位生存期为6个月。17例有反应者中仅6例死亡，该组患者的中位生存期超过13个月。既往治疗后无转移间期的长短与后续化疗反应之间无相关性。
