高剂量化疗联合自体造血干细胞移植治疗复发和高危乳腺癌

目的 探讨高剂量化疗（ＨＤＣ）联合自体造血干细胞移植（ＡＨＳＣＴ）治疗复发和高危乳腺癌的疗效和安全性。方法 对１３例复发和高危乳腺癌患者进行了ＨＤＣ联合ＡＨＳＣＴ治疗，其中７例为既往治疗失败的复发转移患者，２例 姑息性乳房切除术后的Ⅳ期患者，４例为根治性乳房切除术后淋巴结转移１０个以上的Ⅱ，Ⅲ期患者。４例进行自体骨髓移植，６例作了自体外周血干细胞移植。

Combination of high dose chemotherapy with autologous hematopoietic stem cell transplantation for recurrent and high risk breast cancer: a pilot study

OBJECTIVE: To evaluate the therapeutic effectiveness and safety of combined high-dose chemotherapy (HDC) with autologous hematopoietic stem cell transplantation (AHSCT) for recurrent and high-risk breast cancer. METHODS: Thirteen patients with recurrent or high-risk breast cancer underwent HDC with AHSCT. Seven cases had relapsed metastasis who had failed in the previous chemotherapy. Two cases had stage IV disease who had received palliative excision. Four cases had stage II or III breast cancer with over 10 positive axillary lymph nodes who had received radical surgical resection. Four cases received autologous bone marrow transplantation, and six received autologous peripheral blood stem cell transplantation. The consolidation regimen was Thiotepa 500 (250-604) mg/m2, Cyclophosphamide 4.9 (3.3-6.0) g/m2. Eight cases were also given Carboplatin 800 (400-800) mg/m2, and two received Etoposide 830 (800-830) mg/m2 instead of Thiotepa in the consolidation regimen. Twelve cases underwent endocrinotherapy after HDC with AHSCT, six operated cases underwent radiotherapy in the area of chest wall and regional lymph nodes after HDC with AHSCT. RESULTS: After a median follow-up of 8(1-47) months, four cases achieved complete remission (CR) and 3 achieved partial remission (PR) in the 7 cases with relapsed metastasis after induction of chemotherapy, PR patients achieved CR after HDC with AHSCT. The disease free survival (DFS) was 1-31 months in these 7 cases. One of two stage IV cases achieved CR and the other had progressive disease (PD) after induction chemotherapy, but the PD patient achieved PR after HDC with AHSCT, they underwent local radiotherapy after HDC with AHSCT and DFS was 5 and 22 months, respectively. The DFS was from 1-47 months in 4 cases with stage II or III disease. CONCLUSION: HDC with AHSCT is a highly potential therapeutic means for recurrent and high-risk breast cancer paitents.