Chauvergne J, Durand M, Richaud P, Avril A, Hoerni B, Lagarde C
J Gynecol Obstet Biol Reprod (Paris). 1981;10(1):75-85.
74 patients who had adenocarcinoma of the breast that was inoperable at the beginning because of local extension but without inflammation and without diagnosable metastases (T3b, T4, N1, 2 or 3, Mo) were submitted to a therapeutic regime which consisted consecutively of: 1) preliminary chemotherapy, 2) radiotherapy and/or extended radical surgery when there was any residual tumour, and 3) follow-up adjuvant chemotherapy. Two types of combinations of cytostatic drugs were used: adriamycin, vincristin and methotrexate (AVM) for 5-day cycles every 3 weeks, and cyclophosphamide, methotrexate and fluoro-uracil (CMF) in 14-day cycles every 4 weeks. Three to 5 cycles of AVM were used initially, then at first either AVM to a total of 550 mg/m2 adriamycin, or a series of CMF carried on for a year. Complete remission was obtained in 70% of the patients (52 out of 74) at the end of the local-regional treatment. The mean time of remission was 33 months and the mean time of overall survival was 43 months. The best results were obtained in younger women (under 65 years of age) with tumours that were less developed (T3b), and who could take all the adjuvant chemotherapy after they had complete remission. There was no relapse in 37 of the 48 patients in this group (77% of the cases). Overall the treatment was tolerated fairly well and there was no major complication at the time of radiotherapy or surgery. These results are comparable to those from other studies of a similar nature and show a real progress as compared with those that used to be obtained when only local and regional treatments were undertaken. A more thorough follow-up is however necessary since we can hope for improvements to increase the efficacy and tolerance of the treatments, but this form of treatment can here and now be considered as an important factor for improving the survival rate of these very high risk patients.
74例因局部扩散而起初无法手术切除但无炎症且无可诊断转移灶（T3b、T4、N1、2或3、M0）的乳腺癌患者接受了如下连续治疗方案：1）初步化疗；2）若有残留肿瘤，则进行放疗和/或扩大根治手术；3）后续辅助化疗。使用了两种细胞毒性药物联合方案：阿霉素、长春新碱和甲氨蝶呤（AVM），每3周进行为期5天的周期治疗，以及环磷酰胺、甲氨蝶呤和氟尿嘧啶（CMF），每4周进行为期14天的周期治疗。最初使用3至5个周期的AVM，然后要么AVM总共使用550mg/m²阿霉素，要么进行一系列持续一年的CMF治疗。在局部区域治疗结束时，70%的患者（74例中的52例）获得完全缓解。缓解的平均时间为33个月，总生存的平均时间为43个月。在年龄较轻（65岁以下）、肿瘤发展程度较低（T3b）且在完全缓解后能够接受所有辅助化疗的女性患者中取得了最佳结果。该组48例患者中有37例无复发（占病例的77%）。总体而言，治疗耐受性相当良好，放疗或手术时未出现重大并发症。这些结果与其他类似性质的研究结果相当，并且与仅进行局部和区域治疗时所获得的结果相比显示出真正的进步。然而，需要更全面的随访，因为我们希望进一步改进以提高治疗的疗效和耐受性，但目前这种治疗形式可被视为提高这些高风险患者生存率的一个重要因素。
