他莫昔芬对雌激素受体阳性乳腺癌化疗患者预后及血清血管内皮细胞生长因子水平的影响  

Effects of tamoxifen on prognosis and serum vascular endothelial cell growth factor levels in patients with estrogen receptor positive breast cancer chemotherapy

作　　者：夏月[1] 宋志华[1] 方泽波[1] 许玉凤[1] 郭丹[1] XIA Yue;SONG Zhi-hua;FANG Ze-bo;XU Yu-feng;GUO Dan(Department of Pharmacy,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong Province,China)

机构地区：[1]南方医科大学南方医院药学部,广东广州510515

出　　处：《中国临床药理学杂志》2020年第20期3216-3219,共4页The Chinese Journal of Clinical Pharmacology

基　　金：广东省科技计划基金资助项目(2012A030400066)。

摘　　要：目的探讨雌激素受体(ER)阳性乳腺癌化疗患者采用他莫昔芬治疗对患者预后、血清血管内皮细胞生长因子(VEGF)的影响。方法将实施化疗的100例ER阳性患者分为试验组和对照组,每组50例。对照组用长春瑞滨+顺铂(NP方案,第1,8天采用长春瑞滨25 mg·m^-2,静脉滴注,第2~3天给予顺铂40 mg,静脉滴注,每21 d为1个疗程)化疗。试验组在对照组的基础上给予他莫昔芬20 mg,每日1次,口服,连续治疗21 d。比较2组的化疗药物不良反应、血清VEGF水平及患者无进展生存率(DFS)、总生存率(OS)情况。结果治疗后,试验组和对照组的血清VEGF分别为(143.8±42.8),(181.9±63.4)ng·mL^-1,差异有统计学意义(P<0.05)。化疗过程中,试验组和对照组的化疗药物不良反应比较,差异均无统计学意义(均P>0.05)。随访36个月,试验组和对照组的失访率分别为6.00%(3例/50例),10.00%(5例/50),死亡率分别为4.00%(2例/50例),10.00%(5例/50例),差异均无统计学意义(均P>0.05)。2组转移复发、无进展生存时间和总生存时间比较,差异均有统计学意义(均P<0.05)。结论ER阳性乳腺癌化疗患者采用他莫昔芬实施内分泌治疗可有效降低VEGF水平,改善患者的预后。Objective To investigate the effects of tamoxifen on patients with estrogen receptor(ER)-positive breast cancer chemotherapy on the prognosis and serum vascular endothelial growth factor(VEGF).Methods A total of 100 patients with ER-positive who received chemotherapy were divided into treatment group and control gorup,each group 50 cases.Control group was treated with vinorelbine+cisplatin(NP regimen,vinorelbine was used on the 1st and 8th days,25 mg·m^-2,intravenous infusion,cisplatin 40 mg intravenous infusion on day 2-3 of treatment,21 d a course)chemotherapy.Treatment group was given tamoxifen 20 mg,once daily,orally,on the basis of control group,21 d a course.The adverse drug reactions of chemotherapy,serum VEGF levels,disease free survival(DFS)and overall survival(OS)were compared between the two groups.Results After treatment,the serum VEGF levels of treatment group and control group were(143.8±42.8)and(181.9±63.4)ng·mL^-1,with significant difference(P<0.05).During the course of chemotherapy,there was no significant difference in the degree of adverse drug reactions of chemotherapy between treatment group and control group(P>0.05).During the 36 months of follow-up,the lost follow-up rates in treatment group and control group were 6.00%(3 cases/50 cases),10.00%(5 cases/50 cases),the mortality rates were 4.00%(2 cases/50 cases),10.00%(5 cases/50 cases),without significant difference(P>0.05).The metastasis and recurrence,progression-free survival time and overall survival time in treatment group and control group were all with significant difference(all P<0.05).Conclusion Endocrine therapy with tamoxifen in patients with ER-positive breast cancer chemotherapy can effectively reduce VEGF levels and improve patient prognosis.

关 键 词：雌激素受体 乳腺癌 化疗 他莫昔芬 预后 血管内皮细胞生长因子 

分 类 号：R979.1[医药卫生—药品]