De Lena M, Varini M, Zucali R, Rovini D, Viganotti G, Valagussa P, Veronesi U, Bonadonna G
Cancer Clin Trials. 1981 Fall;4(3):229-36.
In a prospective randomized study, the efficacy of two combined modality approaches (chemotherapy plus radiotherapy or chemotherapy plus mastectomy) was tested in a total of 132 women with locally advanced breast cancer. Chemotherapy consisted of Adriamycin plus vincristine (AV) administered for three cycles before either local-regional modality and subsequently for seven additional cycles. Although a higher proportion of women achieved complete remission after mastectomy (100%) compared to women given radiotherapy (60%), the total response rate at the end of combined modality was identical (75%). There was no significant difference between the two treatment groups in terms of patterns of treatment failure, median duration of response, and total survival. Treatment was not influenced by menopausal or estrogen receptor status. Two patients of the surgical group showed Adriamycin-induced cardiomyopathy after cumulative doses less than 500 mg/m2. The results of present study failed to indicate that surgery per se improved the overall results including local control, over radiotherapy in a combined modality setting.
在一项前瞻性随机研究中，对132例局部晚期乳腺癌女性患者测试了两种综合治疗方法（化疗加放疗或化疗加乳房切除术）的疗效。化疗方案为在进行局部区域治疗前给予阿霉素加长春新碱（AV）三个周期，随后再给予七个周期。尽管与接受放疗的女性（60%）相比，接受乳房切除术的女性达到完全缓解的比例更高（100%），但综合治疗结束时的总缓解率相同（75%）。在治疗失败模式、中位缓解持续时间和总生存期方面，两个治疗组之间没有显著差异。治疗不受绝经或雌激素受体状态的影响。手术组中有两名患者在累积剂量小于500mg/m²后出现阿霉素诱导的心肌病。本研究结果未能表明在综合治疗中，手术本身在包括局部控制在内的总体结果方面比放疗更具优势。
