Manni A, Trujillo J E, Pearson O H
Cancer Treat Rep. 1980 Jan;64(1):111-6.
One hundred and ten patients with stage IV breast cancer were treated with five-drug chemotherapy consisting of prednisone, cyclophosphamide, 5-fluorouracil, methotrexate, and vincristine. Sixty-four percent of 97 evaluable patients achieved a remission, with a median duration of 9 months. Age, disease-free interval, and menopausal status did not affect response to chemotherapy. Patients with visceral dominant site of disease tended to have a lower response rate compared to those with bone or soft tissue dominant site of disease. Remission rate was similar in hormone-responsive and -resistant tumors, although median duration of remission was longer in the former group (11 versus 9 months; P less than 0.05). Median survival from onset of metastasis was much longer in patients who had responded to previous endocrine therapy than those who had failed (53 versus 23 months; P less than 0.0005). Thirty-four percent of the 59 patients who were subsequently treated with Adriamycin after either relapse or failure with combination chemotherapy obtained further palliation, with a median duration of 4 1/2 months. We conclude that cytotoxic chemotherapy is effective in hormone-responsive and -resistant tumors. Sequential endocrine therapy and chemotherapy offer long-term survival to patients with hormone-responsive tumors.
110例IV期乳腺癌患者接受了由泼尼松、环磷酰胺、5-氟尿嘧啶、甲氨蝶呤和长春新碱组成的五药联合化疗。97例可评估患者中有64%获得缓解，缓解期中位数为9个月。年龄、无病间期和绝经状态不影响化疗反应。与以骨或软组织为主要病变部位的患者相比，以内脏为主要病变部位的患者缓解率往往较低。激素反应性和激素抵抗性肿瘤的缓解率相似，尽管前一组的缓解期中位数更长（11个月对9个月；P<0.05）。发生转移后开始计算的中位生存期，对既往内分泌治疗有反应的患者比治疗失败的患者长得多（53个月对23个月；P<0.0005）。59例在联合化疗复发或失败后随后接受阿霉素治疗的患者中，34%获得了进一步的姑息治疗，中位持续时间为4.5个月。我们得出结论，细胞毒性化疗对激素反应性和激素抵抗性肿瘤有效。序贯内分泌治疗和化疗为激素反应性肿瘤患者提供了长期生存。
