Long-term follow-up of patients with complete remission following combination chemotherapy for metastatic breast cancer
Long-term follow-up of patients with complete remission following combination chemotherapy for metastatic breast cancer
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DOI：
10.1200/jco.1996.14.8.2197
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发表时间：
1996-08-01
影响因子：
45.3
通讯作者：
Buzdar, AU
中科院分区：
文献类型：
--
作者：
Greenberg, PAC;Hortobagyi, GN;Buzdar, AU
目的：为了确定转移性乳腺癌（MBC）患者的长期临床过程中实现完全缓解与阿霉素，烷化剂的联合化疗方案，患者和方法：为了评估MBC的长期预后，我们回顾了我们的经验，1,581例患者连续阿霉素和烷化剂的一线治疗方案在1973年和1982年之间。治疗最长持续时间为2年。长期生存者的特点进行了评价，并计算进展的风险率。结果：从这组，263（16.6%）达到完全缓解（CR）和49（3.1%）保持CR超过5年。中位持续时间为191个月后，26例患者仍处于首次CR，4例患者在118至234个月的时间内死于CR，18例患者死于乳腺癌，1例患者因转移性疾病存活。与总体CR和总患者人群相比，长期CR组的绝经前患者更多，中位年龄更小，肿瘤负荷更低，体能状态更好。风险函数显示，自开始治疗约3年后，进展风险大幅下降。10例长期CR患者发生第二原发癌：乳腺癌3例，卵巢癌2例，胰腺癌1例，子宫内膜癌1例，结肠癌1例，头颈癌1例，肺癌1例。这些数据表明，一小部分患者在标准化疗方案下实现了长期缓解。需要巩固缓解战略。(C)1996年，美国临床肿瘤学会。
Purpose: To determine the long-term clinical course of patients with metastatic breast cancer (MBC) who achieved a complete remission with doxorubicin-alkylating agent-containing combination chemotherapy programs,Patients and Methods: To assess the long-term prognosis of MBC, we reviewed our experience with 1,581 patients treated on consecutive doxorubicin and alkylating agent-containing front-line treatment protocols between 1973 and 1982. Treatment was administered for a maximum duration of 2 years. Characteristics of long-term survivors were evaluated, and hazard rates for progression were calculated.Results: From this group, 263 (16.6%) achieved complete responses (CR) and 49 (3.1%) remained in CR for more than 5 years. After a median duration of 191 months, 26 patients remain in first CR, four patients died in CR at times ranging from 118 to 234 months, 18 patients died of breast cancer, and one is alive with metastatic disease. Compared with the overall CR and total patient populations, the longterm CR group held more premenopausal patients, a younger median age, a lower tumor burden, and better performance status. The hazard function shows a substantial drop in risk of progression after approximately 3 years from initiation of therapy. Ten long-term CR patients developed second primary cancers: breast (3), ovary (2), pancreas (1), endometrium (1), colon (1), heed and neck (1), and lung (1).Conclusion: Most patients with MBC treated with system therapies have only temporary responses to treatment, but some patients continue in CR following initial treatment. These data show that a small percentage of patient achieve long-term remissions with standard chemotherapy regimens. Remission consolidation strategies are needed. (C) 1996 by American Society of Clinical Oncology.