Smith Ian E, Dowsett Mitch, Yap Yoon-Sim, Walsh Geraldine, Lønning Per E, Santen Richard J, Hayes Daniel
Royal Marsden Hospital Institute of Cancer Research, London, United Kingdom.
J Clin Oncol. 2006 Jun 1;24(16):2444-7. doi: 10.1200/JCO.2005.05.3694.
Aromatase inhibitors (AIs) are now established as adjuvant therapy for early hormone receptor-positive breast cancer in postmenopausal women. Their use is sometimes extended to younger women after chemotherapy-induced amenorrhoea; we have audited this in one institution's breast unit, and we propose guidelines for use in such circumstances.
The use of aromatase inhibitors as adjuvant therapy in younger women age > or = 40 with hormone receptor-positive early breast cancer and chemotherapy-induced amenorrhea has been audited clinically and biochemically. Results A total of 45 such women were identified in the audit, with a median age of 47 years (range, 39 to 52 years). Twelve women (27%) showed a return of ovarian function (10 renewed menses, one pregnancy, one biochemically premenopausal) after starting an AI. Median age at restart of ovarian function was 44 years (range, 40 to 50 years).
AIs may promote recovery of ovarian function in some women with chemotherapy-induced amenorrhea and should be used with caution. Biochemical monitoring of ovarian function requires highly sensitive immunoassays. Guidelines for the selection and delivery of adjuvant endocrine therapy in such patients are proposed.
芳香化酶抑制剂（AIs）现已成为绝经后女性早期激素受体阳性乳腺癌的辅助治疗药物。其使用有时会扩展至化疗导致闭经的年轻女性；我们在一家机构的乳腺科对此进行了审核，并提出了在这种情况下的使用指南。
对年龄≥40岁、激素受体阳性的早期乳腺癌且化疗导致闭经的年轻女性使用芳香化酶抑制剂作为辅助治疗进行了临床和生化审核。结果：审核中总共确定了45名此类女性，中位年龄为47岁（范围39至52岁）。12名女性（27%）在开始使用AI后出现卵巢功能恢复（10例月经恢复，1例怀孕，1例生化检查显示处于绝经前状态）。卵巢功能恢复时的中位年龄为44岁（范围40至50岁）。
芳香化酶抑制剂可能会促进一些化疗导致闭经的女性恢复卵巢功能，应谨慎使用。卵巢功能的生化监测需要高度灵敏的免疫测定法。提出了此类患者辅助内分泌治疗的选择和实施指南。
