戈舍瑞林联合来曲唑治疗高复发风险绝经前乳腺癌的疗效观察  

Effect of goserelin combined with letrozole in premenopausal patients with high recurrence factors breast cancer

作　　者：尹良伟[1] 马海英[2] 许志英[1] 王颖[1] 杜晓红[1] 王苏平[1] 

机构地区：[1]大连市中心医院综合六病房,辽宁大连116033 [2]大连医科大学组织胚胎学教研室,辽宁大连116044

出　　处：《中华肿瘤防治杂志》2012年第24期1879-1882,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:比较戈舍瑞林联合三苯氧胺(TAM)与联合芳香化酶抑制剂(AI)来曲唑治疗高复发风险绝经前乳腺癌的临床疗效。方法:收集2003-06-01-2007-06-01大连市中心医院治疗的50例有高复发风险激素受体阳性的绝经前乳腺癌患者进行回顾性研究。所有患者均为标准治疗后给予戈舍瑞林(3.6mg,每28～30d皮下注射1次,至少1年),其中联合应用TAM(20mg/d,连续5年)的为TAM组(n=25),联合应用来曲唑(2.5mg/d,连续5年)的为AI组(n=25),评价两组的临床疗效和不良反应。结果:AI组患者无进展生存期(PFS)为11～74个月(中位PFS为72个月),高于TAM组的10～74个月(中位PFS为49个月),χ2=5.90,P=0.015 2;两组患者总生存期(OS)分别为28～80和25～78个月,差异无统计学意义,χ2=1.56,P=0.2115。两组患者用药后主要不良反应为骨关节疼痛不适感、潮热或多汗、阴道干涩和焦虑易怒等,差异无统计学意义,P>0.05。结论:戈舍瑞林联合AI治疗高复发风险激素受体阳性的绝经前乳腺癌患者,疗效明显优于戈舍瑞林联合TAM,而且不良反应可耐受。OBJECTIVE： To explore the efficacy of goserelin combined with tamoxifen （TAM） versus goserelin com- bined with letrozole, a kind of aromatase inhibitor （AI）, in premenopausal patients with high recurrence factors breast cancer. METHODS： Fifty hormone receptor positive premenopausal breast cancer patients with high recurrence factors in Dalian centre hospital from 06-01-2003 to 06-01-2007 treated with goserelin （3.6 mg hypodermic injection every 28-30 days,at least 1 year） plus TAM （20rag/d, for 5 years）as TAM group （n= 25） or goserelin （3.6 mg hypodermic injection every 28-30 days,at least 1 year） plus letrozole （2.5 mg/d,for 5 years） as AI group （n=25） after standard adjuvant ther- apy in Dalian centre hospital from June 1,2003 to June 1,2007 were retrospectively reviewed. The clinical efficacy and ad- verse toxicities were analyzed for two groups. RESULTS： The progression-free survival （PFS） of AI group（11-74 months, median PFS 72 months） was higher than that of TAM group（10-74 months, median PFS 49 months, X2= 5. 90, P= 0. 015 2）; The over all survival （OS） of the two groups had no significant difference（28-80 months vs 25-78, X2= 1.56, P=0. 211 5）. The main adverse toxicities were joint pain and discomfort,hot flashes,vaginale dryness,anxiety and irrita- bility. The two groups had no significant difference（P〉0.05）. CONCLUSIONS： The efficacy of goserelin combined with letrozole is superior to that of goserelin combined with TAM for hormone receptor positive premenopausal breast cancer patients with high recurrence factors. The adverse toxicities of this combination are tolerable.

关 键 词：乳腺肿瘤 内分泌腺肿瘤 治疗 戈舍瑞林 三唑类 回顾性分析 

分 类 号：R737.9[医药卫生—肿瘤]