Love R R
Cancer Prevention and Breast Programs, University of Wisconsin Comprehensive Cancer Center, Madison.
Cancer Invest. 1992;10(6):587-93. doi: 10.3109/07357909209024821.
Adjuvant tamoxifen therapy is associated with modest improvement in disease-free and overall survival in women with invasive axillary node-negative breast cancer. The preponderance of data supporting these general conclusions are from trials in postmenopausal women; in premenopausal women data appear convincing regarding disease-free, but not overall, survival. Firm conclusions regarding magnitude of benefit related to presence of different prognostic factors cannot be drawn at present. In postmenopausal women tamoxifen appears to alter favorably some risk factors for cardiovascular diseases and osteoporosis, which are the most common causes of mortality or morbidity in older American women. Adjuvant tamoxifen is associated with a significantly reduced risk of second primary breast cancer. Major serious risks of tamoxifen therapy include depression, and possibly thrombophlebitis and uterine endometrial cancer. Symptomatic vasomotor and gynecological side effects are frequent. Decision making with women should include assessment of these multisystem benefits and risks.
辅助性他莫昔芬治疗可使腋窝淋巴结阴性的浸润性乳腺癌女性患者的无病生存期和总生存期有适度改善。支持这些总体结论的大部分数据来自绝经后女性的试验；在绝经前女性中，关于无病生存期的数据似乎令人信服，但关于总生存期的数据则不然。目前尚无法就与不同预后因素相关的获益程度得出确切结论。在绝经后女性中，他莫昔芬似乎能有利地改变一些心血管疾病和骨质疏松症的风险因素，而这两种疾病是美国老年女性死亡或发病的最常见原因。辅助性他莫昔芬与第二原发性乳腺癌风险的显著降低相关。他莫昔芬治疗的主要严重风险包括抑郁症，可能还有血栓性静脉炎和子宫内膜癌。有症状的血管舒缩症状和妇科副作用很常见。与女性患者共同决策应包括对这些多系统获益和风险的评估。
