Thuerlimann Beat, Koeberle Dieter, Senn Hans-Joerg
Department of Internal Medicine, Division Oncology/Haematology, Kantonsspital, CH-9007 St. Gallen, Switzerland.
Eur J Cancer. 2007 Jan;43(1):46-52. doi: 10.1016/j.ejca.2006.09.003. Epub 2006 Nov 7.
Treatment guidelines are useful tools that enable physicians to integrate the latest clinical research into their practices. The large volume of rapidly evolving clinical data in breast cancer has been summarised and incorporated into treatment recommendations by well-known and reliable institutions, including the National Comprehensive Cancer Network, the American Society for Clinical Oncology, the European Society for Medical Oncology and the St. Gallen International Consensus Panel. Adjuvant therapy is a key component of breast cancer treatment, and many of the current consensus guidelines now recognise the important role of the aromatase inhibitors as an alternative to or in sequence after tamoxifen, hitherto the standard adjuvant treatment of choice for receptor-positive women. Data from ongoing trials such as the Breast International Group 1-98 trial and those still in the accrual phase will be forthcoming and will likely result in a further refinement of treatment recommendations over the course of the next few years. Despite the availability of such guidelines, however, there is evidence that adherence to and implementation of treatment recommendations is less than optimal. Further research is needed to determine more effective means of disseminating those clinical recommendations that can have a significant impact on treatment strategies and ultimately improve outcomes in breast cancer.
治疗指南是实用工具，能让医生将最新临床研究融入其诊疗实践。大量快速发展的乳腺癌临床数据已被包括美国国立综合癌症网络、美国临床肿瘤学会、欧洲医学肿瘤学会和圣加仑国际共识小组在内的知名可靠机构进行了总结，并纳入治疗建议中。辅助治疗是乳腺癌治疗的关键组成部分，目前许多共识指南现在都认识到芳香化酶抑制剂作为他莫昔芬的替代药物或在他莫昔芬之后使用的重要作用，迄今为止，他莫昔芬一直是激素受体阳性女性的标准辅助治疗选择。来自正在进行的试验（如国际乳腺癌研究组1-98试验）以及仍处于入组阶段的试验的数据即将公布，可能会在未来几年进一步完善治疗建议。然而，尽管有这些指南，但有证据表明，对治疗建议的遵循和实施情况并不理想。需要进一步研究以确定更有效的方法来传播那些对治疗策略有重大影响并最终改善乳腺癌治疗结果的临床建议。
