Andersson M, Storm H H, Mouridsen H T
Danish Cancer Registry, Copenhagen.
Acta Oncol. 1992;31(2):259-63. doi: 10.3109/02841869209088912.
The occurrence of new primary tumours among postmenopausal patients with primary breast cancer subsequent to adjuvant treatment in Denmark was assessed by linkage to the cancer registry. Following primary surgery, patients in low risk of recurrence (n = 1,828) received no further treatment while patients in high risk randomly received either adjuvant radiotherapy alone (n = 846) or radiotherapy + tamoxifen 30 mg daily for 48 weeks (n = 864). With a median follow-up of 8 years, the incidence of tumours in the contralateral breast was similar among tamoxifen-treated, and non-treated high-risk patients even after adjusting for tumours arising within the first year. The standardized incidence ratio for endometrial cancer was 1.9 (95% confidence interval 0.8-3.9) among tamoxifen treated, the cumulative incidence 1% compared to 0.3% among non-treated patients (p = 0.11). The cumulative risk of non-lymphocytic leukaemia was 0.9% and 0.1% among irradiated and non-irradiated patients respectively (p = 0.4). Prolonged follow-up of tamoxifen-treated patients with regard to new tumours is recommended.
通过与癌症登记处的数据关联，评估了丹麦绝经后原发性乳腺癌患者在辅助治疗后发生新原发性肿瘤的情况。初次手术后，复发风险低的患者（n = 1,828）不再接受进一步治疗，而高风险患者则随机接受单独辅助放疗（n = 846）或放疗 + 每日30 mg他莫昔芬治疗48周（n = 864）。中位随访8年后，即使在对第一年出现的肿瘤进行校正后，他莫昔芬治疗组和未治疗的高风险患者对侧乳腺肿瘤的发生率仍相似。他莫昔芬治疗组子宫内膜癌的标准化发病率比为1.9（95%置信区间0.8 - 3.9），累积发病率为1%，而未治疗患者为0.3%（p = 0.11）。接受放疗和未接受放疗的患者非淋巴细胞白血病的累积风险分别为0.9%和0.1%（p = 0.4）。建议对他莫昔芬治疗的患者进行关于新肿瘤的长期随访。
