Repetto L, Simoni C, Venturino A, Biancardi V, Gasco M, Campora E, Rosso R
Department of Medical Oncology I, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Anticancer Res. 1995 Sep-Oct;15(5B):2297-300.
Comorbidity has important implications in older breast cancer patients. Whether elderly patients are more likely to have a decreased tolerance to antineoplastic agents is still a question of debate. Chemotherapy-naive women with metastatic or locally advanced breast cancer aged > or = 68 years entered a phase II trial of Mitoxantrone given day 1 q 21 days. The dose of the drug was dependent on performance status (PS) and number of "minor" comorbid conditions: patients with ECOG PS = 2 and/or > or = 2 comorbid conditions received 10 mg/m2 and those with PS < 2 and < 2 comorbid conditions received 14 mg/m2. Twenty-seven patients, median age 77 years (range 68-86), received a median number of 5 courses (range 1-9). All 27 patients were evaluable for toxicity and 23 cases (patients receiving at least 3 courses) were evaluable for response. Partial response was observed in 6/23 cases (26%) and median duration of response was 6 months (range 3-9). Median overall survival was 8 months (range 2-34). Among cases receiving 10 mg/m2, 4 PR, 4 SD and 2 P were observed and in cases treated with 14 mg/m2, 2 PR, 5 SD and 6 P occurred. Treatment was well tolerated and no grade 4 toxicity was encountered. Mitoxantrone is an effective and well-tolerated regimen in elderly breast cancer patients presenting with comorbid conditions.
合并症在老年乳腺癌患者中具有重要意义。老年患者对抗肿瘤药物的耐受性是否更易降低仍是一个有争议的问题。年龄≥68岁、未经化疗的转移性或局部晚期乳腺癌女性患者进入一项米托蒽醌的II期试验，米托蒽醌于第1天给药，每21天一次。药物剂量取决于体能状态（PS）和“轻度”合并症的数量：东部肿瘤协作组（ECOG）PS = 2和/或≥2种合并症的患者接受10mg/m²，PS < 2且合并症< 2种的患者接受14mg/m²。27例患者，中位年龄77岁（范围68 - 86岁），接受的中位疗程数为5个疗程（范围1 - 9个疗程）。所有27例患者均可评估毒性，23例（接受至少3个疗程的患者）可评估疗效。23例中有6例（26%）观察到部分缓解，中位缓解持续时间为6个月（范围3 - 9个月）。中位总生存期为8个月（范围2 - 34个月）。接受10mg/m²的患者中，观察到4例部分缓解、4例病情稳定和2例疾病进展；接受14mg/m²治疗的患者中，出现2例部分缓解、5例病情稳定和6例疾病进展。治疗耐受性良好，未出现4级毒性反应。对于合并有合并症的老年乳腺癌患者，米托蒽醌是一种有效且耐受性良好的治疗方案。
