Toda K, Hirata K, Sato T, Okazaki M, Asaishi K, Narimatsu E
First Department of Surgery, Sapporo Medical University School of Medicine, Japan.
Surg Today. 1998;28(5):509-16. doi: 10.1007/s005950050175.
To evaluate the effects of intraarterial infusion chemotherapy (IAIC) for advanced breast cancer, we examined the grade of histological responses of preoperative IAIC on tumors at the time of operation and estimated the patients' prognoses for 19 years. IAIC was done preoperatively using timely epochal anticancer drugs on 105 patients with locally advanced (Stage IIIa, IIIb) and metastatic (Stage IV) breast cancer. The survival rate of the Stage IIIb patients who showed a good histological response (Grade IIb< or =) to IAIC was 68.1% for 5 years, and 62.4% for 10 years, respectively. This was in contrast to that of the patients classified as Stage IIIb who showed a poor histological response (Grade IIa> or =) to IAIC. On the other hand, there was no significant difference in the survival rates between the Stage IIIa and IV patients with good and poor histological responses to IAIC. However, the findings showed that a good histological response to IAIC reflected a prolonged survival while the Stage IIIb and IV patients acquired a "down clinical staging" by IAIC. These results strongly suggest that IAIC thus appears to be a useful modality in the multidisciplinary treatment of advanced breast cancer, especially for Stage IIIb patients.
为评估动脉内灌注化疗（IAIC）对晚期乳腺癌的疗效，我们检查了术前IAIC对手术时肿瘤的组织学反应分级，并对105例局部晚期（Ⅲa期、Ⅲb期）和转移性（Ⅳ期）乳腺癌患者进行了19年的预后评估。对105例局部晚期（Ⅲa期、Ⅲb期）和转移性（Ⅳ期）乳腺癌患者术前使用适时的抗癌药物进行IAIC治疗。对IAIC组织学反应良好（Ⅱb级及以下）的Ⅲb期患者5年生存率为68.1%，10年生存率为62.4%。这与对IAIC组织学反应较差（Ⅱa级及以上）的Ⅲb期患者形成对比。另一方面，对IAIC组织学反应良好和较差的Ⅲa期和Ⅳ期患者生存率无显著差异。然而，研究结果表明，对IAIC的良好组织学反应反映了生存期延长，而Ⅲb期和Ⅳ期患者通过IAIC实现了“临床分期降低”。这些结果强烈表明，IAIC似乎是晚期乳腺癌多学科治疗中的一种有用方式，尤其是对Ⅲb期患者。
