Outcome of extensive evaluation before adjuvant therapy in women with breast cancer and 10 or more positive axillary lymph nodes.
Outcome of extensive evaluation before adjuvant therapy in women with breast cancer and 10 or more positive axillary lymph nodes.
复制标题
对腋窝淋巴结有 10 个或以上阳性的乳腺癌女性患者进行辅助治疗前进行广泛评估的结果。
DOI：
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发表时间：
1996
影响因子：
45.3
通讯作者：
C. Girouard
中科院分区：
文献类型：
--
作者：
M. Crump;P. Goss;M. Prince;C. Girouard
目的
旨在评估对高危、淋巴结阳性乳腺癌女性进行广泛筛查对隐匿性转移性疾病检测的效果以及患者参加在标准辅助治疗中添加高剂量化疗和自体骨髓支持 (ABMT) 的随机试验的资格。
患者和方法
本报告对已切除 T1-3N1,2 原发性乳腺癌和≥10 个阳性腋窝淋巴结（转诊可能参与试验）的女性进行了评估。转诊医生对所有患者进行了正常的胸部 X 光检查、骨扫描和肝脏超声检查。那些对随机试验提供知情同意书的人根据方案接受了头部、胸部、腹部和骨盆的计算机断层扫描（CT）以及双侧骨髓活检的进一步评估；通过任何这些测试检测到的患有转移性疾病的患者被排除在研究注册之外。
结果
1993 年 2 月至 1995 年 4 月期间，对 44 名女性进行了评估。其中 14 名女性因拒绝参加临床评估或外部放射学研究审查或存在转移性疾病而没有接受进一步的方案分期。其余 30 例接受了额外检查，其中 7 例（23%；95% 置信区间 [CI]，12% 至 41%）通过 CT 扫描（四名患者）或骨髓活检（三名患者）检测到常规筛查未检测到的转移灶。
结论
尽管评估的患者数量很少，但这些数据表明，在 II 期试验中，腋窝淋巴结阳性的女性接受 ABMT 作为辅助化疗的一部分，其结果的部分改善可能是由于排除了隐匿性转移性疾病的患者。这些排除的重要性只能通过正在进行的随机对照试验来确定。
PURPOSE
To evaluate the effect of extensive screening of women with high-risk, node-positive breast cancer on the detection of occult metastatic disease and patient eligibility for a randomized trial of the addition of high-dose chemotherapy and autologous bone marrow support (ABMT) to standard adjuvant therapy.
PATIENTS AND METHODS
Women with resected T1-3N1,2 primary breast cancer and > or = 10 positive axillary lymph nodes referred for possible trial participation were evaluated for this report. All had normal chest x-ray, bone scan, and liver ultrasound performed by the referring physician. Those who provided informed consent for the randomized trial were further evaluated according to protocol with computed tomographic (CT) scans of the head, chest, abdomen, and pelvis and bilateral bone marrow biopsies; those with metastatic disease detected by any of these tests were excluded from study registration.
RESULTS
Forty-four women were evaluated between February 1993 and April 1995. Fourteen did not undergo further protocol staging because of refusal to participate or the presence of metastatic disease on clinical assessment or review of outside radiologic studies. The remaining 30 underwent additional investigations, and seven (23%; 95% confidence interval [CI], 12% to 41%) had metastases detected by CT scanning (four patients) or bone marrow biopsy (three patients) not detected by routine screening.
CONCLUSION
Although the number of patients evaluated is small, these data suggest that some of the improvement in outcome of women with > or = 10 positive axillary lymph nodes who receive ABMT as part of adjuvant chemotherapy in phase II trials may be from the exclusion of patients with occult metastatic disease. The importance of these exclusions can only be determined by ongoing, randomized controlled trials.
对可手术淋巴结阳性乳腺癌女性进行五种和三种药物化疗和化学免疫治疗的随机试验。
DOI：
10.1200/jco.1983.1.2.138
发表时间：
1983
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Tormey,DC;Weinberg,VE;Holland,JF;Weiss,RB;Glidewell,OJ;Perloff,M;Falkson,G;Falkson,HC;Henry,PH;Leone,LA
通讯作者：
Leone,LA
影响因子：
158.5
作者：
WOOD, WC;BUDMAN, DR;HENDERSON, IC
通讯作者：
HENDERSON, IC