T3b-T4 breast cancer: factors affecting results in combined modality treatments
T3b-T4 breast cancer: factors affecting results in combined modality treatments
复制标题
T3b-T4 乳腺癌：影响联合治疗结果的因素
DOI：
10.1007/bf00121498
复制
发表时间：
1983
影响因子：
4
通讯作者：
G. Bonadonna
中科院分区：
文献类型：
--
作者：
P. Valagussa;M. Zambetti;P. Bignami;M. Lena;M. Varini;R. Zucali;D. Rovini;G. Bonadonna
1973年至1980年间，共有277例t3b - t4乳腺癌患者在米兰癌症研究所接受了联合治疗。化疗（CT）由AV组成，即阿霉素（60-75 mg/m2day 1）和长春新碱（1.2 mg/m2days 1和8），在局部局部模式之前给予3 - 4个周期。局部-区域治疗包括198例放疗（RT）和79例手术(S)。然后对总共205名患者进行了额外的化疗。在没有远处转移的情况下，接受CT + RT治疗的患者获得良好局部控制的频率（63.9%）明显低于接受CT + RT + CT（75.4%）和CT + S + CT （82.3%，P= 0.033）的患者。此外，与接受CT + RT治疗的患者相比，接受更长时间化疗组的进展自由（FFP）和总生存期（SURV）显著优于接受CT + RT治疗的患者（FFP:P·0001;SURV:P= 0.002）。检查的所有变量都不能影响反应率，而腋窝淋巴结状态和肿瘤大小对FFP和SURV的持续时间起主要作用。我们的研究结果表明，需要一种更积极的治疗方法来改善目前在这一疾病阶段的结果。为了克服局部复发的问题，除炎性癌外，所有患者的治疗可能都应从细胞减少手术开始，然后进行术后放疗。然后应该进行全身治疗以控制远处的微转移。
Two hundred and seventy-seven consecutive patients with T3b-T4breast cancer referred to the Milan Cancer Institute between 1973 and 1980 were treated with a combined modality approach. Chemotherapy (CT) consisted of AV, i.e. adriamycin (60–75 mg/m2day 1) and vincristine (1·2 mg/m2days 1 and 8) and was given for three to four cycles prior to local regional modality. Local-regional treatment consisted of either radiotherapy (RT) in 198 patients or surgery (S) in 79 women. Additional chemotherapy was then administered to a total of 205 patients.In the absence of distant metastases, frequency of good local control was significantly inferior in patients given CT + RT (63·9 per cent) compared to those treated with CT + RT + CT (75·4 per cent) and CT + S + CT (82·3 per cent,P=0·033). Also freedom from progression (FFP) and overall survival (SURV) were significantly superior in the groups receiving more prolonged chemotherapy treatment compared to patients treated with CT + RT (FFP:P·0001; SURV:P=0·002). None of the variables examined was able to affect the response rate, while axillary nodal status and tumor size played a major role in the duration of FFP and SURV.Our findings indicate that a more aggressive treatment is needed to improve current results in this stage of disease. To overcome the problem of local-regional recurrence, treatment should probably begin with cytoreductive surgery followed by postoperative radiotherapy in all patients with the exception of those having inflammatory carcinoma. Systemic treatment should then be delivered to control distant micrometastases.