High-dose chemotherapy with autologous stem cell transplantation in patients with oligometastatic breast cancer
High-dose chemotherapy with autologous stem cell transplantation in patients with oligometastatic breast cancer
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DOI：
10.1038/sj.bmt.1704613
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发表时间：
2004-10-01
影响因子：
4.8
通讯作者：
Harstrick, A
中科院分区：
文献类型：
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作者：
Bojko, P;Welt, A;Harstrick, A
这项前瞻性试验的目的是研究一种联合治疗方法，包括手术或放疗局部巩固和高剂量化疗（HDC），然后进行外周血干细胞（PBSC）移植。总共入组了48例接受表阿霉素和环磷酰胺或紫杉醇和顺铂诱导化疗（取决于既往辅助化疗）后适合局部治疗的寡转移性乳腺癌患者。中位随访时间为41个月（范围：7-85个月）。47例患者采集外周血干细胞，其中40例接受了1 ~ 2个疗程的HDC。局部治疗37例。未发生给药相关死亡。在47例可评价患者中，36例（意向治疗人群的75%）在完成治疗后没有疾病或完全缓解的证据。6例患者（12.5%）部分缓解，2例患者（4%）无变化，3例患者（6%）疾病进展。中位至进展时间和总生存期分别为17.5个月（95%置信区间（CI），14-21个月）和42.2个月（95% CI，33-52个月），27%的患者在5年后无进展。总之，寡转移性乳腺癌患者可以安全地接受这种联合治疗方案，并有希望获得无复发生存率。
The purpose of this prospective trial was to study a combined-modality treatment including local consolidation by surgery or radiotherapy and high-dose chemotherapy (HDC) followed by peripheral-blood stem-cell (PBSC) transplantation. In all, 48 patients with oligometastatic breast cancer amenable to local treatment after induction chemotherapy with epirubicin and cyclophosphamide or paclitaxel and cisplatin, depending on prior adjuvant chemotherapy, were enrolled. The median follow-up was 41 months (range, 7-85 months). PBSC were collected in 47 patients, and 40 received one or two courses of HDC. Local therapy was given in 37 patients. No treatment-related deaths occurred. Of 47 evaluable patients, 36 (75% of intention-to-treat population) had no evidence of disease or complete remission after completion of therapy. Six patients (12.5%) had partial response, two patients (4%) no change, and three patients (6%) progressive disease. The median time to progression and overall survival was 17.5 (95% confidence interval (CI), 14-21 months) and 42.2 months (95% CI, 33-52 months), respectively, and 27% of patients were progression free after 5 years. In conclusion, patients with oligometastatic breast cancer can be treated safely with this combined modality protocol with promising relapse-free survivals.