Bonadonna G, Rossi A, Tancini G, Bajetta E, Marchini S, Brambilla C, Tesoro Tess J D, Valagussa P, Banfi A, Veronesi U
Cancer Treat Rep. 1981;65 Suppl 1:61-5.
Adjuvant trials ongoing at the Istituto Nazionale Tumori of Milan for operable breast cancer with nodal involvement are reviewed in this paper. In the first trial (cyclophosphamide, methotrexate, 5-fluorouracil [CMF] versus control), the early 5-year results confirm the usefulness of combination chemotherapy in significantly affecting the relapse-free survival (RFS) and total survival rates. The degree of axillary node involvement remains the most important prognostic indicator also in patients receiving adjuvant chemotherapy. The contention concerning the therapeutic effect of CMF in pre- versus postmenopausal women is overcome by the observation that about 80% of patients receiving greater than 85% of the planned dose are surviving relapse free at 5 years regardless of their menopausal status. The 3-year results of the second CMF trial indicate that both RFS and total survival are comparable between the groups receiving 12 or 6 cycles of adjuvant CMF. The results were not affected by drug-induced amenorrhea nor by estrogen receptor status. Provided the percent of dose administered is high, there is probably no real advantage in prolonging CMF chemotherapy beyond the sixth month. However, the results are still preliminary.
本文回顾了米兰国立肿瘤研究所正在进行的针对伴有淋巴结受累的可手术乳腺癌的辅助试验。在第一项试验中（环磷酰胺、甲氨蝶呤、5-氟尿嘧啶[CMF]与对照组对比），早期5年结果证实了联合化疗在显著影响无复发生存期（RFS）和总生存率方面的有效性。腋窝淋巴结受累程度在接受辅助化疗的患者中仍然是最重要的预后指标。关于CMF在绝经前与绝经后女性中治疗效果的争论，通过以下观察得以解决：约80%接受计划剂量85%以上的患者，无论其绝经状态如何，5年时均无复发生存。第二项CMF试验的3年结果表明，接受12周期或6周期辅助CMF治疗的组间RFS和总生存率相当。结果不受药物性闭经或雌激素受体状态的影响。如果给药剂量百分比高，将CMF化疗延长至6个月以上可能没有真正优势。然而，结果仍属初步。
