Survival of High Risk Breast Cancer Patients Treated with Cyclophosphamide, Methotrexate and 5-FU as Adjuvant Therapy

高危險性乳癌患者之輔助性化療效果

張意恆(Yi-Heng Chang) ； 陳火木(For-Moon Chen) ； 呂志得(Jyh-Der Leu) ； 劉千如(Chien-Ru Liu) ； 洪啟輔(Chi-Fu Hung) ； 鄭企峰(Chi-Feng Cheng) ； 王威堯(Wei-Yao Wang) ； 林哲斌(Che-Pin Lin)

《北市醫學雜誌》 2卷7期 (2005/07) Pp. 639-647

https://doi.org/10.6200/TCMJ.2005.2.7.07

摘要

早期乳癌患者若有四顆或四顆以上腋下淋巴轉移，其預後極為不佳。我們於1996年七月開始嘗試用兩種反應率最高的藥物（adriamycin及paclitaxel）做為前導，銜接以cyclophosphamide，methotrexate，及5-FU(CMF)這種作用機轉不同的傳統處方，治療了十六個合於條件的病患。在平均追蹤了五十五個月後，結果五年的無病存活率為82%，五年的總體存活率為92%，急性及長期的毒性都相當輕微。我們認為，這是一種安全有效的輔助化療處方，值得臨床運用。

關鍵字

乳癌 ； 輔助性化療 ； adriamycin ； paclitaxel ； 存活率

並列摘要

Background and Purpose: To evaluate the survival outcome of a new adjuvant chemotherapeutic regimen (adriamycin plus paclitaxel followed by cyclophosphamide, methotrexate, and 5-FU) for high-risk breast cancer patients who had four or more axillary nodes metastasis. Methods: From July 1996 to September 2001, 16 eligible patients were given adriamycin plus paclitaxel for 5 courses followed by cyclophosphamide, methotrexate and 5-FU (CMF) for 6 courses. Adjuvant radiation therapy was given concurrently with CMF. If the hormonal receptor status of the tumor was positive, patients were given adjuvant tamoxifen for 5 years after completion of all chemotherapies. Results: After median follow-up of 55 months, 2 out of 16 patients relapsed and died. The other 14 patients were alive and disease free. The 5 years disease-free survival rate was 82%, overall survival rate 92%. Acute and late toxicities were modest and manageable. Conclusion: This is an effective and well-tolerated adjuvant regimen and worth further large randomized studies to confirm its advantage over the other anthracycle-taxane based regimens.

並列關鍵字

breast cancer ； adjuvant chemotherapy ； Paclitaxel ； Adriamycin ； survival