Viens P, Penault-Llorca F, Jacquemier J, Gravis G, Cowen D, Bertucci F, Houvenaeghel G, Blaise D, Maraninchi D
Department of Medicine, Institut Paoli-Calmettes, Marseille, France.
Bone Marrow Transplant. 1998 Feb;21(3):249-54. doi: 10.1038/sj.bmt.1701074.
Inflammatory breast cancer still has a poor prognosis despite improvements related to the introduction of neoadjuvant chemotherapy. The purpose of this study was to evaluate pathologic response rate and outcome of patients receiving high-dose chemotherapy with haematopoietic stem cell support for IBC. Seventeen consecutive patients with IBC received an association of mitoxantrone (36 mg/m2), cyclophosphamide (120 mg/kg), melphalan (140 mg/m2), with stem cell transplantation (SCT) following four to five cycles of cyclophosphamide (1000 mg/m2), doxorubicin (75 mg/m2) and 5FU (500 mg/m2). Mastectomy was performed a median of 2 months (range 1.5-45) after high-dose chemotherapy and was followed by radiotherapy. Macroscopic and microscopic pathologic complete response rates were respectively 56 and 39%. With a median follow-up of 36 months (range 17-52) 10 patients remain alive free of disease and seven patients have relapsed. Two relapses occurred in the group of patients with pathologic CR and five in the group with residual tumour. These results show that high-dose chemotherapy (HDC) with alkylating agents followed by SCT allows a very high tumour eradication in inflammatory breast cancer, suggesting a possible global benefit in progression-free survival and survival which remains to be demonstrated prospectively.
尽管新辅助化疗的应用带来了一些改善，但炎性乳腺癌的预后仍然很差。本研究的目的是评估接受高剂量化疗联合造血干细胞支持治疗炎性乳腺癌患者的病理缓解率和预后情况。17例连续的炎性乳腺癌患者接受了米托蒽醌（36mg/m²）、环磷酰胺（120mg/kg）、美法仑（140mg/m²）联合治疗，并在接受四至五个周期的环磷酰胺（1000mg/m²）、阿霉素（75mg/m²）和5-氟尿嘧啶（500mg/m²）治疗后进行干细胞移植（SCT）。在高剂量化疗后中位2个月（范围1.5 - 45个月）进行乳房切除术，随后进行放疗。宏观和微观病理完全缓解率分别为56%和39%。中位随访36个月（范围17 - 52个月），10例患者无病存活，7例患者复发。病理完全缓解组有2例复发，残留肿瘤组有5例复发。这些结果表明，烷化剂联合高剂量化疗（HDC）后进行SCT可使炎性乳腺癌的肿瘤根除率非常高，提示在无进展生存期和总生存期方面可能有整体获益，这仍有待前瞻性研究证实。
