高剂量表阿霉素治疗进展期和晚期乳腺癌

目的评价高剂量表阿霉素（ＨＤ－ＥＰＩ）合并环磷酰胺（ＣＴＸ）、氟脲嘧啶（５－Ｆｕ）治疗进展期和晚期乳腺癌的安全性和有效性。方法对３２例可评价的Ⅲ、Ⅳ期乳腺癌患者静脉给予ＣＴＸ６００ｍｇ／ｍ２、ＥＰＩ９０ｍｇ／ｍ２～１１０ｍｇ／ｍ２、５－Ｆｕ９００ｍｇ／ｍ２,每２１天重复。并与３０例非同期低剂量组比较（ＥＰＩ为５０ｍｇ／ｍ２）。结果高剂量组的总有效率为７１．９％,完全缓解率为１２．５％,明显高于低剂量组（５６．７％和６．７％）;初治的有效率（８０．０％）略高于复治者（６８．２％）。全组中位缓解期７．４个月,中位生存期１２．５个月。白细胞减少为主要的毒副反应,发生率为８９．５％（６８／７６）,Ⅲ、Ⅳ度分别为２７．６％和１８．４％;胃肠道毒性为轻、中度,未见明显的心肝肾毒性。结论ＨＤ－ＥＰＩ＋ＣＴＸ＋５－Ｆｕ方案治疗晚期乳腺癌安全有效,可在临床进一步试用

A clinical report of high-dose epirubicin combined with cyclophosphamide and fluorouracil for advanced breast cancer

OBJECTIVE: To evaluate safety and efficacy of high-dose epirubicin combined with cyclophosphamide and fluorouracil for advanced breast cancer. METHODS: Thirty two cases with stage III and IV breast cancer were treated with epirubicin (EPI) 90-110 mg/m2, cyclophosphamide (CTX) 600 mg/m2 and 5-fluorouracil (5-Fu) 900 mg/m2 every 21 days. The therapeutic effect was compared with that in patients treated with low-dose EPI(50 mg/m2). RESULTS: The response rate (RR) in patients treated with high-dose EPI was 71.9% (CR = 4, PR = 19) which was significantly better than that in the low-dose EPI-treated patients (CR = 2, PR = 5). The therapeutic effect was slightly better in patients initially diagnosed than in patients in recurrence (RR: 80% vs 68.2%) the median remission and surriving peroid was 7.4 months and 12.5 months, respectively. The major side effect was leukopenia. Mild to moderate GI tract side effects were obsevved. There was no significant cardiotoxicity. CONCLUSION: High-dose EPI combined with CTX, 5-Fu is a safe and effective regimen for patients with advanced breast cancer worthy of further clinical trial.