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    Color-Matrix Cancer Staging and Treatment Handbook

    Edwand H.Lin,MD· Richard Lozano,RPh· Daniel D,Karp,MD

    THE UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER

    Making Cancer History

    Third Edition 2004

    【仅选取化疗方案部分】

    AIDS-Related Kaposi's Sarcoma

    DrugDose and ScheduleLiposomal

    DaunorubicinLiposomal daunorubicin (DaunoXome) 40mg/m2 IV over 60 minutes

    Repeat every 14 days.Liposomal

    DoxorubicinLiposomal doxorubicin (Doxil) 20mg/m2 IV over 60 minutes

    Repeat every 21 days.PaclitaxelPaclitaxel 135mg/m2 IV over 3 hours

    Repeat every 21 days.

    or

    Paclitaxel 135mg/m2 IV over 1 hours

    Repeat every14 days.Breast Cancer-Adjuvant Therapy

    RegimenDrug Doses and SchedulesDFS

    RateOS

    RateGrade 3 and 4 Side Effects;

    Reference(s)FACFluorouracil 500 mg/m2 IV days 1 and 4

    Doxorubicin 50 mg/m2 CI over 72 hours

    Starting day 1

    Cyclophosphamide 500 mg/m2 IV day 1

    Repeat every 21 days for 6 cycles.63% at 7 yr

    (stage ll)69% at 7 yr

    (stage ll)Neutropenia,Mucositis,Nausea or vomiting,Neutropenic fever

    Buzdar A. In:salmon SE, ed. Adjuvant

    Therapy of Cancer Vll. Philadeophia,Lippincott,1993. Cancer 53:384, 1984.Sequential

    Paclitaxel→

    FACPaclitaxel 80 mg/m2 IV over 1 hours

    Weekly for 12 weeks

    followed by

    FAC (as above) for 4 cycles86% at

    48 moToo earlyNeutropenia, Mucositis,Nausea or vomiting,Neutropenic fever

    Clin Cancer Res 8:1073, 2002FECFluorouracil 500 mg/m2 IV day 1

    Epirubicin 100 mg/m2 IV day 1

    Cyclophosphamide 500 mg/m2 IV day 1

    Repeat every 21 days for 6 cycles.66.3% at 5 yr

    50.7% at

    10 yr77.4% at 5 yr

    54.8% at 10 yrNeutropenia,Mucositis,Nausea or vomiting,Neutropenic fever

    J Clin Oncol 19:602, 2001

    Proc Am Soc Clin Oncol A93, 2003CEF*Cyclophosphamide 75mg/m2 PO days 1-14

    Epirubicin 60 mg/m2 IV day 1 and 8

    Fluorouracil 500 mg/m2 IV days 1 and 8

    Repeat every 21 days for 6 cycles.

    *Requires prophylactic antibiotics or growth

    factor support.63% at 60

    mo(vs 53% for CMF)

    52% at 10

    yr (vs 45%

    for CMF)77% at 60

    mo(vs 70% for CMF)

    62% at 10

    yr (vs 58%

    for CMF)Neutropenia, Mucositis,Nausea or vomiting,Neutropenic fever

    J Clin Oncol 6:2651, 1998

    San Antonio Breast Cancer

    Symposium A17, 2002ACDoxorubicin 60 mg/m2 IV day 1

    Cyclophosphamide 600 mg/m2 IV day 1

    Repeat every 21 days for 4 cycles.62% at 3 yr83% at 3 yrNeutropenia, Mucositis,Nausea or vomiting,Neutropenic fever

    J Clin Oncol 8:1483, 1990Sequential

    AC→paclitaxel

    Doxorubicin 60 mg/m2 IV day 1

    Cyclophosphamide 600 mg/m2 IV day 1

    Repeat every 21 days for 4 cycles.

    followed by

    Paclitaxel 175 mg/m2 IV over 3 hours

    Repeat every 21 days for 4 cycles.70% at 5 yr80% at 5 yrNeutropenia, Mucositis,Nausea or vomiting,Neutropenic fever

    Semin Oncol 22:18, 1995

    J Clin Oncol 21:976, 2003CAFCyclophosphamide 600 mg/m2 IV day 1

    Doxorubicin 60 mg/m2 IV bolus day 1

    Fluorouracil 600 mg/m2 IV days 1 and 8

    Repeat every 28 days for 6 cycles.74% at 3 yr

    92% at 3 yr

    Neutropenia,Mucositis,Nausea or vomiting,Neutropenic fever

    J Natl Casncer Inst 90:1205, 1998

    N Engl J Med 330:1253, 1994

    EC(60)Epirubicin 60 mg/m2 IV day 1

    Cyclophosphamide 500 mg/m2 IV day 1

    Repeat every 21 days for 8 cycles.

    72% at 3 yr

    89% at 3 yr

    Neutropenia, Mucositis,Nausea or vomiting,Neutropenic fever

    J Clin Oncol 19:3103, 2001EC(100)Epirubicin 100 mg/m2 IV day 1

    Cyclophosphamide 830 mg/m2 IV day 1

    Repeat every 21 days for 8 cycles.

    80% at 3 yr92% at 3 yrNeutropenia, Mucositis,Nausea or vomiting,Neutropenic fever

    J Clin Oncol 19:3103, 2001TAC*Docetaxel 75 mg/m2 IV over 1 hour day 1

    Doxorubicin 50 mg/m2 IV day 1

    Cyclophosphamide 500 mg/m2 IV day 1

    Repeat every 21 days for 6 cycles.

    *Requires growth factor support prophylactic antibiotics. Doxorubicin should be given before

    docetaxel.75% at 5 yr87% at 5 yrNeutropenia, Mucositis,Nausea or vomiting,Neutropenic fever

    Martin M, et al. San Antonio Breast

    Cancer Symplsium, A43, 2003CMF OralCyclophosphamide 100 mg/m2/day POdays 1-14

    Methotrexate 40 mg/m2 IV days 1 and 8*

    Fluorouracil 600 mg/m2 IV days 1 and 8*

    Repeat every 28 days for 6 cycles.

    *For patients > 60 years, reduce methotrexate dose

    to 30 mg/m2 and fouorouracil dose to 400 mg/m2.71% at 12 yr

    80% at 12 yr

    Neutropenia, Mucositis,Nausea or vomiting,Neutropenic fever

    N Engl J Med 294:405, 1976

    N Engl J Med 332:901, 1995CMF IVCyclophosphamide 600 mg/m2 IV day 1

    Methotrexate 40 mg/m2 IV day 1

    Fluorouracil 600 mg/m2 IV days 1 and 8

    Repeat every 28 days for 6 cycles.82% at 5 yr88% at 5 yrNeutropenia, Mucositis,Nausea or vomiting,Neutropenic fever

    J Clin Oncol 14:1982, 1996TamoxifenTamoxifen 20 mg PO daily for 5 years in

    Hormone receptor-positive women

    Regardless of menopausal status or age79.2% at

    10yr (vs 64.3% for placebo)

    There was a 58%

    reduction in the risk of ontralateral

    breast cancer.78.9% at 10yr (vs 73.3% for placebo)Lancet 351:1451, 1998

    Anastrozole

    阿那曲唑Anastrozole 1 mg PO daily for 5 years

    In hormone receptor-positive

    Postmenopausal women sequentially after

    Chemotherapy.86.9% at 4 yr

    There was a 58%

    Reduction in the risk of contralateral

    breast cancer.Data not

    matureCancer 98:1802, 2003Tam→

    Letrozole

    来曲唑

    Tamoxifen 20 mg PO daily for 5 years

    Followed by

    Letrozole 2.5 mg daily for 5 years

    In hormone receptor-positive

    Postmenopausal women sequentially after

    Chemotherapy.93% at 4 yr (vs 87% for same tam. Regimen followed by placebo rather than letrozole)

    Median Follow-UP,2.4 yr

    Data not

    matureN Engl J Med 349:19, 2003Tam→

    Exemestane

    依西美坦Tamoxifen 20 mg PO daily for 2-3 years......（后略) ......