Brufman G, Haim N, Ben-Baruch N, Sulkes A
Department of Oncology, Hadassah Hospital, Jerusalem, Israel.
J Chemother. 1993 Feb;5(1):43-6. doi: 10.1080/1120009x.1993.11739208.
Ninety-three evaluable patients with metastatic breast cancer previously treated with chemotherapy, received mitoxantrone as a single agent (14 mg/m2, by rapid intravenous infusion, once every 3 weeks). Patients received a median of 7 courses (range 2 to 18), with a mean cumulative total dose of 133 mg (range 36 to 342). A complete response (CR) was achieved in 2 patients (2%). Partial response (PR) was observed in 23 patients (25%). The overall response rate (CR+PR) was thus 27%, with a median duration of 9 months (range 3 to 18). Responses were observed in all metastatic sites, except for brain and peritoneum. Stabilization (S) occurred in 26 patients (28%). The remaining 42 patients (45%) showed clear progression of their metastatic disease while on therapy. The actuarial 24-month survival for the whole group was 13%, increasing to 29% in responders (CR+PR), as compared with only 10% for non-responders (S+P; P < 0.0001). Mitoxantrone was generally well tolerated; nausea, vomiting and hair loss were mild. Nine out of 625 treatment cycles resulted in leukopenic fever with uneventful recovery. All patients had serial MUGA scans; 3 patients (cumulative total doses of 200, 250 and 342 mg, respectively) developed a significant drop in the left ventricular ejection fraction. Clinical evidence of congestive heart failure was observed in one patient who had received prior doxorubicin-based adjuvant chemotherapy. Mitoxantrone seems to be as effective as other drugs given singly or in combination as second-line chemotherapy in patients with metastatic breast cancer. Its low morbidity makes its use attractive in this setting.
93例曾接受过化疗的可评估转移性乳腺癌患者，接受米托蒽醌单药治疗（14mg/m²，快速静脉输注，每3周1次）。患者接受的疗程中位数为7个（范围2至18个），平均累积总剂量为133mg（范围36至342mg）。2例患者（2%）达到完全缓解（CR）。23例患者（25%）观察到部分缓解（PR）。因此，总缓解率（CR+PR）为27%，中位缓解持续时间为9个月（范围3至18个月）。除脑和腹膜外，在所有转移部位均观察到缓解。26例患者（28%）病情稳定（S）。其余42例患者（45%）在治疗期间出现转移性疾病明显进展。全组患者24个月精算生存率为13%，缓解者（CR+PR）升至29%，而无缓解者（S+P）仅为10%（P<0.0001）。米托蒽醌总体耐受性良好；恶心、呕吐和脱发症状较轻。625个治疗周期中有9个周期出现白细胞减少性发热，但恢复顺利。所有患者均进行了系列多门电路平衡门控心血池扫描；3例患者（累积总剂量分别为200、250和342mg）左心室射血分数显著下降。1例曾接受过基于阿霉素的辅助化疗的患者出现充血性心力衰竭的临床证据。对于转移性乳腺癌患者，米托蒽醌作为二线化疗单独或联合使用时似乎与其他药物一样有效。其低发病率使其在这种情况下的应用具有吸引力。
