Acute and Late Toxicity Following Adjuvant High-Dose Chemotherapy for High-Risk Primary Operable Breast Cancer A Quality Assessment Study
Acute and Late Toxicity Following Adjuvant High-Dose Chemotherapy for High-Risk Primary Operable Breast Cancer A Quality Assessment Study
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高危原发性可手术乳腺癌辅助大剂量化疗后的急性和晚期毒性质量评估研究
DOI：
10.1080/028418602321028300
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发表时间：
2002
期刊：
影响因子：
3.1
通讯作者：
S. W. Hansen
中科院分区：
文献类型：
--
作者：
I. Svane;K. Homburg;C. Kamby;D. Nielsen;O. Roer;Dorte Sliffsgaard;H. Johnsen;S. W. Hansen
从1996年到2000年，大剂量化疗联合造血干细胞支持作为一种辅助治疗策略用于治疗有5个以上阳性结节的原发高危乳腺癌患者。这项单一机构的研究包括52名年龄56岁的乳腺癌患者和S的6个肿瘤阳性腋窝淋巴结。治疗方案包括至少3个疗程的FEC(5-氟尿嘧啶、表阿霉素、环磷酰胺)，随后是大剂量化疗(环磷酰胺、硫替巴、卡铂)，并辅以自体外周血干细胞回输。这项研究的重点是质量控制，包括毒性评估、支持性治疗和干细胞产品的评估。3/37例患者的干细胞产物中有3个细胞角蛋白19阳性细胞。有关器官毒性的数据用于评估短期和长期副作用。发现了大量的急性毒性和频繁的导管相关感染。远期毒副反应包括肺弥散功能减退(36例)、乏力(14例)、关节痛/肌痛(10例)、神经毒性(9例)和记忆丧失(4例)。然而，大多数毒性反应为1-2级，并在两年内可逆。没有发生与治疗相关的死亡。在中位随访30个月(范围11-57个月)内，25%的患者复发。治疗开始三年后，无复发存活率为75%，总存活率为88%。总体而言，大剂量化疗的耐受性相对较好，毒性可控，支持治疗的要求也是可以接受的。到目前为止，大剂量化疗还没有被证明优于常规剂量的辅助化疗，因此未来有必要专注于设计良好的随机研究。
From 1996 to 2000, high-dose chemotherapy with haematopoietic stem-cell support was used as an adjuvant treatment strategy for management of primary high-risk breast cancer patients with more than five positive nodes. This single institution study included 52 women aged h 56 years with primary operable breast cancer and S 6 tumour-positive axillary lymph nodes. The treatment regimen consisted of at least three initial courses of FEC (5-fluorouracil, epirubicin, cyclophosphamide) followed by high-dose chemotherapy (cyclophosphamide, thiotepa, carboplatin) supported by autologous peripheral blood stem-cell reinfusion. This study focuses on quality control including evaluation of toxicity, supportive therapy and assessment of the stem-cell products. Cytokeratin 19 positive cells were found in the stem-cell product from 3/37 patients. Data regarding organ toxicity were used for evaluation of short- and long-term side effects. Substantial acute toxicity and frequent catheter-related infections were found. Long-term toxicities included reduced lung diffusion capacity (n=36), fatigue (n=14), arthralgia/myalgia (n=10), neurotoxicity (n=9) and memory loss (n=4). However, most toxicities were grade 1-2 and reversible within two years. No treatment-related death occurred. Within a median follow-up of 30 months (range, 11-57), 25% of the patients had relapsed. Recurrence-free survival was 75% and overall survival was 88% three years after the start of treatment. Overall, high-dose chemotherapy was relatively well tolerated, with manageable toxicity and an acceptable requirement of supportive therapy. Until now, high-dose chemotherapy has not proven superior to conventional-dose adjuvant chemotherapy, therefore it is necessary in the future to focus on well-designed randomized studies.
循环神经母细胞瘤细胞污染外周血干细胞收获物。
影响因子：
20.3
作者：
Moss,TJ;Sanders,DG;Lasky,LC;Bostrom,B
通讯作者：
Bostrom,B