Tominaga T, Nomura Y, Uchino J, Hirata K, Kimura M, Yoshida M, Aoyama H, Kinoshita H, Koyama H, Monden Y, Takashima S, Ogawa M
Department of Surgery, Tokyo Metropolitan Komagome Hospital, Japan.
Jpn J Clin Oncol. 1998 Apr;28(4):250-4. doi: 10.1093/jjco/28.4.250.
Multi-combination chemotherapy consisting of anthracyclines has been effective but has not invariably prolonged the survival period in advanced/recurrent breast cancer. The possibility has been discussed that chemoendocrine therapy combined with endocrine agents is more effective.
In order to evaluate the toxicity and efficacy of a new endocrine therapy for advanced/recurrent breast cancer, we ran a pilot study during the period from July 1994 to July 1996.
Twenty-two patients with advanced/recurrent breast cancer were treated with chemoendocrine therapy consisting of cyclophosphamide (100 mg/body) p.o. daily for 14 days, with adriamycin (40 mg/m2) i.v. and 5-fluorouracil (500 mg/body) i.v. on day 1 (repeated every 3 weeks for 9 weeks) (CAF therapy), and high-dose toremifene (120 mg/body) p.o. daily. Of 20 evaluable patients, two showed complete response (10%), eight partial response (40%), six no change (30%) and four progressive disease (20%). The overall response rate was 50%, and the median duration of response was 69.5 days (28-133+ days). The major toxicities were drug-induced alopecia, gastrointestinal toxicity and hematological toxicity, but these were clinically well tolerated. No serious cardiac, liver or renal symptom was seen.
Based on these results, we consider the addition of high-dose toremifene to the CAF therapy to be useful in the treatment of advanced and recurrent breast cancer.
由蒽环类药物组成的多药联合化疗虽有疗效，但在晚期/复发性乳腺癌中并不能始终延长生存期。已讨论过化疗内分泌治疗联合内分泌药物可能更有效。
为评估一种用于晚期/复发性乳腺癌的新内分泌治疗的毒性和疗效，我们在1994年7月至1996年7月期间进行了一项试点研究。
22例晚期/复发性乳腺癌患者接受了化疗内分泌治疗，包括口服环磷酰胺（100mg/体），每日1次，共14天，第1天静脉注射阿霉素（40mg/m²）和5-氟尿嘧啶（500mg/体）（每3周重复1次，共9周）（CAF治疗），以及口服高剂量托瑞米芬（120mg/体），每日1次。在20例可评估患者中，2例完全缓解（10%），8例部分缓解（40%），6例病情稳定（30%），4例病情进展（20%）。总缓解率为50%，中位缓解持续时间为69.5天（28 - 133 +天）。主要毒性为药物性脱发、胃肠道毒性和血液学毒性，但临床耐受性良好。未观察到严重的心脏、肝脏或肾脏症状。
基于这些结果，我们认为在CAF治疗中添加高剂量托瑞米芬对晚期和复发性乳腺癌的治疗有用。
