Antman K, Ayash L, Elias A, Wheeler C, Schwartz G, Mazanet R, Tepler I, Schnipper L E, Frei E
Department of Medicine, Dana-Farber Cancer Institute, Boston, MA 02115.
J Natl Cancer Inst Monogr. 1994(16):91-4.
The analysis was undertaken to determine if the time to progression and survival for women with breast cancer treated with high-dose chemotherapy after a conventional-dose induction therapy differs significantly for women younger and older than 40 years of age. All patients treated in phase II or III protocols of high-dose chemotherapy for breast cancer are included in this analysis. Women were treated on one of six protocols: four sequential phase II protocols for metastatic breast cancer involving cyclophosphamide at a dose of 6000 mg/m2, thiotepa at 500 mg/m2, and carboplatin at 800 mg/m2 (CTCb) chemotherapy; one phase II study of CTCb chemotherapy for stage III or inflammatory breast cancer; and a Cancer and Leukemia Group B phase III study of cyclophosphamide, carmustine, and cisplatin for women with more than 10 involved lymph nodes after primary therapy. Eligibility criteria for the patients with metastatic disease included histologically documented breast cancer, at least a partial response to conventional dose therapy, no prior pelvic radiotherapy, cumulative doxorubicin of less than 500 mg/m2, and physiologic age of 18-55 years. Patients with inadequate renal, hepatic, pulmonary, and cardiac function or tumor involvement of marrow or central nervous system were excluded. Of 99 registered patients, three (3%) died of toxicity. There were no toxic deaths in protocols for stage II and III disease, and to date none of these patients have relapsed. Thus, there are no differences by age for these studies.(ABSTRACT TRUNCATED AT 250 WORDS)
本分析旨在确定接受常规剂量诱导治疗后再接受高剂量化疗的乳腺癌女性患者,年龄小于40岁和大于40岁者在疾病进展时间和生存期方面是否存在显著差异。所有参与乳腺癌高剂量化疗II期或III期方案治疗的患者均纳入本分析。女性患者接受六种方案之一的治疗:四种转移性乳腺癌的序贯II期方案,包括剂量为6000 mg/m²的环磷酰胺、500 mg/m²的噻替派和800 mg/m²的卡铂(CTCb)化疗;一项针对III期或炎性乳腺癌的CTCb化疗II期研究;以及一项癌症与白血病B组针对初始治疗后有超过10个受累淋巴结女性患者的环磷酰胺、卡莫司汀和顺铂III期研究。转移性疾病患者的入选标准包括组织学确诊的乳腺癌、对常规剂量治疗至少有部分反应、既往未接受盆腔放疗、阿霉素累积剂量小于500 mg/m²以及生理年龄在18至55岁之间。肾功能、肝功能、肺功能和心功能不全或骨髓或中枢神经系统有肿瘤累及的患者被排除。99名登记患者中,3人(3%)死于毒性反应。II期和III期疾病方案中无毒性死亡病例,且迄今为止这些患者均未复发。因此,这些研究在年龄方面无差异。(摘要截短于250字)