Lancet:氟尿嘧啶与提高乳腺癌无病存活率无关

2015-03-06 赵洲译 MedSci原创

氨茴环霉素和紫杉烷相结合的化疗方案可以改善早期乳腺癌的结果。最广泛地与紫杉烷相结合的药物有阿霉素和环磷酰胺(AC),或者表阿霉素和环磷酰胺(EC),或者氟尿嘧啶、阿霉素和环磷酰胺(FAC),或者氟尿嘧啶、表阿霉素和环磷酰胺(FEC)。氟尿嘧啶对AC或者EC治疗处方的贡献尚不明确。多个随机试验曾尝试评估剂量密度化疗在早期乳腺癌治疗中的作用。但鲜有试验是进行了合适的研究设计。因此,剂量密度辅助化疗

氨茴环霉素和紫杉烷相结合的化疗方案可以改善早期乳腺癌的结果。最广泛地与紫杉烷相结合的药物有阿霉素和环磷酰胺(AC),或者表阿霉素和环磷酰胺(EC),或者氟尿嘧啶、阿霉素和环磷酰胺(FAC),或者氟尿嘧啶、表阿霉素和环磷酰胺(FEC)。氟尿嘧啶对AC或者EC治疗处方的贡献尚不明确。多个随机试验曾尝试评估剂量密度化疗在早期乳腺癌治疗中的作用。但鲜有试验是进行了合适的研究设计。因此,剂量密度辅助化疗的作用现在仍有争议。

究竟表阿霉素、环磷酰胺和紫杉醇(EC-P)加上氟尿嘧啶治疗早期乳腺癌中作为辅助治疗是否有利,研究人员进行了一次2×2因素、非双盲的三期临床试验。试验选取了18-70岁的可进行手术的、阳性肿瘤的早期乳腺癌患者。病人被随机地均分为四组。545人注射EC-P(每三周一次,记作q3EC-P),q3FEC-P组有544人(氟尿嘧啶加EC-P),q2EC-P组共502人,q2FEC-P组共500人。主要监测指标是无病存活率。在两个FEC-P组,出现了270例无病死亡,两个EC-P组出现251例无病死亡。

对数据结果进行分析,相对于标准间隔化疗治疗早期乳腺癌,剂量密度辅助治疗可以提高无病生存存活率。而附加使用氟尿嘧啶与提高无病生存存活率无关。
 
原始出处:

Lucia Del Mastro et al.Fluorouracil and dose-dense chemotherapy in adjuvant treatment of patients with early-stage breast cancer: an open-label, 2 × 2 factorial, randomised phase 3 trial.Lancet.Published Online March 2, 2015

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    2016-01-06 howi
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    2015-05-16 ljjj1053

    很不错学习了

    0

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    2015-03-06 zhouanxiu

    有指导意义的研究

    0

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