Jonat W, Maass H, Braun M, Winter G
J Cancer Res Clin Oncol. 1984;107(3):233-7. doi: 10.1007/BF01032614.
This pilot study includes 115 consecutive patients admitted in the period from 1978 to 1981. Patients eligible for this study were at high risk according to the TNM classification with stages pT1-pT3 and pN+, MO. Primary therapy included modified radical mastectomy and axillary-node clearance, one or more ipsilateral nodes being involved in routine histology. All tumors were assayed for estrogen and progesterone receptors. According to the result of the estrogen receptor assay, estrogen-receptor-positive patients were treated with Tamoxifen 30 mg/day for a period of 2 years. Estrogen-receptor-negative patients were treated with cytoxan, methotrexate, and 5-fluorouracil or adriblastin, cytoxan. After a median observation time of 36 months, overall there have been 31 recurrences: 9 = 17.3% in the estrogen-receptor-positive group and 22 = 34.9% in the estrogen-receptor-negative group. The analysis of different subgroups showed no significant differences, either in relation to axillary lymph-node status or in relation to menopausal status in the endocrine-treated compared with the polychemotherapy group. This result suggests, especially in the subgroup of patients with involvement of one to three axillary nodes, that estrogen-receptor-positive and estrogen-receptor-negative patients should be considered as separate groups when adjuvant therapy is indicated. Possibly hormone-receptor-positive patients may benefit from endocrine therapy and do not need polychemotherapy.
这项初步研究纳入了1978年至1981年期间连续收治的115例患者。根据TNM分类，符合本研究条件的患者为高危患者，分期为pT1 - pT3和pN +、M0。初始治疗包括改良根治性乳房切除术和腋窝淋巴结清扫术，常规组织学检查发现一个或多个同侧淋巴结受累。所有肿瘤均检测雌激素和孕激素受体。根据雌激素受体检测结果，雌激素受体阳性患者接受他莫昔芬30 mg/天治疗，为期2年。雌激素受体阴性患者接受环磷酰胺、甲氨蝶呤和5 - 氟尿嘧啶或阿霉素、环磷酰胺治疗。经过36个月的中位观察期，总体共有31例复发：雌激素受体阳性组9例（17.3%），雌激素受体阴性组22例（34.9%）。不同亚组的分析显示，在内分泌治疗组与多药化疗组之间，无论是腋窝淋巴结状态还是绝经状态，均无显著差异。这一结果表明，尤其是在腋窝淋巴结有1至3个受累的患者亚组中，当需要进行辅助治疗时，雌激素受体阳性和雌激素受体阴性患者应被视为不同的组。可能激素受体阳性患者可从内分泌治疗中获益，而无需多药化疗。
