Koyama H, Wada T, Takahashi Y, Nishizawa Y, Iwanaga T, Aoki Y, Terasawa T, Kosaki G, Kajita A, Wada A
Cancer. 1980 Dec 1;46(11):2373-9. doi: 10.1002/1097-0142(19801201)46:11<2373::aid-cncr2820461112>3.0.co;2-h.
A controlled trial of surgical adjuvant chemotherapy for breast cancer was carried out using 551 Japanese patients. Single or combined treatment with mitomycin C (0.2 mg/kg i.v. three times within five days postoperatively) and cyclophosphamide (100 mg postoperatively daily for four months or longer) was used after radical surgery. In patients of the chemotherapy group with one to three lymph nodes involved in the axilla, the five-year cancer-free survival rate was 84.8% compared with 57.3% in the control group (P < 0.05), and the five-year cumulative recurrence in distant sites was 5.1% compared with 31.1% in the control (P < 0.05). The effectiveness of chemotherapy was much less marked in patients without nodal metastasis and with four or more nodes involved. Histologically, scirrhous cancer was the type that responded most favorably to chemotherapy, even in patients without axillary involvement. Premenopausal patients benefited more than postmenopausal patients from chemotherapy. A combination of mitomycin C and cyclophosphamide was more effective than their use singly. The present chemotherapy regimen was effective primarily in moderately advanced stages of breast cancer with decreased incidence of distant metastasis.
对551名日本患者进行了乳腺癌手术辅助化疗的对照试验。根治性手术后，采用丝裂霉素C（术后5天内静脉注射0.2mg/kg，共3次）和环磷酰胺（术后每日100mg，持续4个月或更长时间）进行单一或联合治疗。在腋窝有1至3个淋巴结受累的化疗组患者中，五年无癌生存率为84.8%，而对照组为57.3%（P<0.05）；远处部位的五年累积复发率为5.1%，而对照组为31.1%（P<0.05）。在无淋巴结转移和有4个或更多淋巴结受累的患者中，化疗效果不太明显。组织学上，即使在无腋窝受累的患者中，硬癌也是对化疗反应最有利的类型。绝经前患者比绝经后患者从化疗中获益更多。丝裂霉素C和环磷酰胺联合使用比单独使用更有效。目前的化疗方案主要对中度晚期乳腺癌有效，可降低远处转移的发生率。
