Tomiak E, Piccart M, Mignolet F, Sahmoud T, Paridaens R, Nooy M, Beex L, Fentiman I S, Muller A, van der Schueren E, Rubens R D
Eur J Cancer. 1996 Oct;32A(11):1876-87. doi: 10.1016/0959-8049(96)00189-x.
This retrospective study was undertaken to characterise the natural history of women achieving complete response (CR) following standard dose combination chemotherapy for metastatic breast cancer (MBC), and to analyse the significance of various patient, disease and treatment characteristics in determining survival and time to disease progression. 75 patients achieving a CR following standard dose combination chemotherapy or combined chemoendocrine therapy for MBC have been studied. At a median follow-up of 6 years, 28% of patients are still alive, with 18 of 21 patients showing no evidence of disease. 15 (20%) patients, with median follow-up of 61 months from start of chemotherapy, have never experienced relapse. Median overall survival is 32.5 months. Multivariate analysis for survival identified inclusion of anthracyclines and WHO performance status as significant predictors of good long-term outcome. Concomitant hormonotherapy almost reached statistical significance in our multivariate analysis. Neither dominant site of disease nor disease-free interval were significant determinants of complete remission. With conventional dose combination chemotherapy, approximately 20% of women with MBC who have achieved a clinical CR have been shown to be expected to remain alive and free of disease at 5 years. Inclusion of an anthracycline appears to be an important determinant of durability of CR and patient survival.
本回顾性研究旨在描述转移性乳腺癌（MBC）患者在接受标准剂量联合化疗后达到完全缓解（CR）的自然病程，并分析各种患者、疾病和治疗特征在确定生存及疾病进展时间方面的意义。我们研究了75例在接受MBC标准剂量联合化疗或联合化疗内分泌治疗后达到CR的患者。中位随访6年时，28%的患者仍存活，21例患者中有18例无疾病证据。15例（20%）患者自化疗开始后的中位随访时间为61个月，从未经历复发。中位总生存期为32.5个月。生存的多因素分析确定蒽环类药物的使用和世界卫生组织（WHO）体能状态是长期良好预后的重要预测因素。在我们的多因素分析中，同时进行的激素治疗几乎达到统计学意义。疾病的主要部位和无病间期均不是完全缓解的重要决定因素。采用传统剂量联合化疗时，约20%达到临床CR的MBC女性患者预计在5年时仍存活且无疾病。蒽环类药物的使用似乎是CR持续时间和患者生存的重要决定因素。
