Nystedt M, Berglund G, Bolund C, Brandberg Y, Fornander T, Rutqvist L E
Department of Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
Acta Oncol. 2000;39(8):959-68. doi: 10.1080/02841860050215945.
After primary surgery, 149 premenopausal breast cancer patients, with node-negative disease, were randomized to one of four treatment groups: goserelin, tamoxifen, goserelin plus tamoxifen or to a systematically untreated control group. The aim was to assess the effects of adjuvant endocrine therapy in terms of physical symptoms and perception of anxiety and depressive symptoms. Assessments were made before randomization, at 3-4 months and at 12 months. Treatment with goserelin resulted in early and more intense menopausal symptoms, while the effects of tamoxifen were slower and milder. The side effects with goserelin appeared to be alleviated by concurrent tamoxifen except for vasomotor symptoms (hot flashes, sweating, feeling warm). No significant group differences were found for anxiety and depressive symptoms. In conclusion, chemical castration with goserelin was associated with the highest level of physical symptoms. The group treated with tamoxifen alone showed the lowest levels of symptoms among the treatment groups, except for vaginal discharge and irregular bleedings.
在进行初次手术后，149名绝经前、淋巴结阴性的乳腺癌患者被随机分为四个治疗组之一：戈舍瑞林组、他莫昔芬组、戈舍瑞林加他莫昔芬组或系统未治疗的对照组。目的是评估辅助内分泌治疗对身体症状以及焦虑和抑郁症状感知的影响。在随机分组前、3至4个月时以及12个月时进行评估。使用戈舍瑞林治疗导致更早且更强烈的绝经症状，而他莫昔芬的效果则较缓慢且较轻微。除血管舒缩症状（潮热、出汗、感觉发热）外，同时使用他莫昔芬似乎可减轻戈舍瑞林的副作用。在焦虑和抑郁症状方面未发现显著的组间差异。总之，使用戈舍瑞林进行化学去势与最高水平的身体症状相关。在各治疗组中，单独使用他莫昔芬治疗的组除白带和不规则出血外症状水平最低。
