来曲唑在绝经后受体阳性乳腺癌新辅助内分泌治疗中的应用  

Application of Letrozole in Neoadjuvant Endocrine Therapy for Postmenopausal Breast Cancer with Receptor Positive

作　　者：李艳萍[1] 高宏[1] 冯宇[1] 吕淑贞[1] 

机构地区：[1]北京世纪坛医院肿瘤外科乳腺中心,北京100038

出　　处：《中国现代应用药学》2010年第4期365-369,共5页Chinese Journal of Modern Applied Pharmacy

摘　　要：目的评估来曲唑在绝经后雌激素和／或孕激素受体（ER／PR）阳性乳腺癌新辅助内分泌治疗中临床应用价值、耐受性及与临床病理因素的相关性。方法38例绝经后中晚期乳腺癌，给予来曲唑治疗3～12个月，平均4个月，并观察疗效，手术前后肿瘤标本进行ER，PR，Her-2，Ki-67检测，术后继续服用来曲唑，并随访1～3年。结果临床客观缓解68．4％，超声客观缓解55．3％，3例进展（7．9％）后改为化疗。病理评价（33例手术）完全缓解1例（2．6％），部分缓解26例（78．8％），稳定6例（18．2％）。治疗后33例（86．8％）病人行手术治疗，其中保乳手术7例（21．2％），改良根治术26例（78．8％）。组织学分级低的肿瘤有效率高（P〈0．05）。疗效与HER-2表达情况无关，Ki-67在治疗后下降，治疗前后相比差异显著（氏0．05）。治疗中6例病人出现Ⅰ级不良反应（15．8％）。部分病人治疗后雌或孕激素受体表达消失。结论绝经后受体阳性乳腺癌采用来曲唑新辅助内分泌治疗安全、有效、耐受性好，治疗后保乳率高，特别对年老体弱者是一良好选择。OBJECTIVE To assess clinical application value, survivability, and the correlation to clinicopathologic factors of neoadjuvant endocrine therapy for postmenopausal breast cancer patients with ER（＋） and/or PR（＋）. METHODS A total of 38 elderly patients with breast cancer were given letrozole for 3-12 months, 4 months in average, ER, PR, Her-2 and Ki-67 were detected before and after surgery, all patients were followed up for one to three years. RESULTS Clinical objective response is 68.4%. Sonography objective response is 55.3%. Complete remission achieved in I case （2.6%）, partial remission in 26 cases（78.8%）, no change in 6 cases（18.2%）, the disease in 3 cases（7.9%） was progressed and changed into chemotherapy later. 33 cases（86.8%） were performed operation after treatment, 7 cases（21.2%） treated with BCS and 26 cases（78.8%）with masteetomy. There are no correlation found between response and the expression of HER-2. The expression of Ki-67 is remarkable decreased after treatment with letrozole （P〈0.05）. Several patients lose their ER or PR expressions after treatment. CONCLUSION Neoadjuvant endocrine therapy with letrozole for postmenopausal patients with receptor-positive breast cancer could effectively decrease or delay the advancement of tumor, the method is effective and safe, especially for elderly women whom are sickish and ineligible for radical mastectomy.

关 键 词：来曲唑 绝经后乳腺癌 新辅助内分泌治疗 受体阳性 

分 类 号：R979.1[医药卫生—药品]