van Nes J G H, Seynaeve C, van de Velde C J H, Nortier J W R
Leids Universitair Medisch Centrum, Leiden.
Ned Tijdschr Geneeskd. 2006 Dec 30;150(52):2863-9.
Postmenopausal patients with hormone-sensitive breast cancer may be eligible for adjuvant hormone therapy. - For years, tamoxifen was the treatment of choice. - However, the side effects associated with tamoxifen, such as endometrial cancer and thromboembolic disorders, and the search for more effective agents have led to the introduction of new hormonal therapies. - The results of randomised trials with the third-generation aromatase inhibitors anastrozole, exemestane and letrozole demonstrate improved efficacy compared to tamoxifen. - Using aromatase inhibitors, the disease-free survival is prolonged and recent data from some studies also show a benefit in overall survival. - Aromatase inhibitors are associated with specific side effects consisting of osteoporosis/increased incidence of fractures and myalgia/arthralgia.
绝经后激素敏感性乳腺癌患者可能适合辅助激素治疗。多年来,他莫昔芬一直是首选治疗药物。然而,与他莫昔芬相关的副作用,如子宫内膜癌和血栓栓塞性疾病,以及对更有效药物的探索,导致了新的激素疗法的引入。使用第三代芳香化酶抑制剂阿那曲唑、依西美坦和来曲唑的随机试验结果表明,与他莫昔芬相比,疗效有所提高。使用芳香化酶抑制剂可延长无病生存期,一些研究的最新数据也显示对总生存期有益。芳香化酶抑制剂会引起特定的副作用,包括骨质疏松/骨折发生率增加和肌痛/关节痛。