Harbeck Nadia, Haidinger Renate
Frauenklinik der Technischen Universität München, Ismaninger Strasse 22, Münich 81675, Germany.
Breast Cancer Res Treat. 2007;105 Suppl 1(Suppl 1):91-103. doi: 10.1007/s10549-007-9703-8. Epub 2007 Oct 3.
The impact of improved treatments for the management of hormone-sensitive breast cancer extends beyond clinical responses. Thanks to appropriate literature and access to the internet, patient awareness of treatment options has grown and patients are now, in many cases, able to engage their oncologists in informed conversations regarding treatment and what to expect in terms of efficacy and safety. Indeed, patients realize that although there is no cure for metastatic disease, treatment can greatly reduce the risk of progression and in the adjuvant setting, where treatment is administered with a curative intent, current treatment options reduce the risk of relapse. The approval of letrozole throughout the breast cancer continuum has provided patients with many reassuring options. The improvement in outcome with letrozole is achieved without a detrimental effect on overall quality of life. Adverse events such as hot flushes, arthralgia, vaginal dryness, and potential osteoporosis are most significant from the patient's perspective, and it is important that caregivers pay attention to patients experiencing these events, as they can impact compliance unless effectively explained and managed. The major benefits of letrozole are to improve prospects for long-term survivorship in the adjuvant setting and to delay progression and the need for chemotherapy in the metastatic setting.
激素敏感性乳腺癌治疗方法的改进所产生的影响不仅限于临床反应。得益于合适的文献资料以及互联网的普及,患者对治疗方案的认知有所提高,如今在很多情况下,患者能够与肿瘤医生就治疗以及疗效和安全性方面的预期进行明智的交流。实际上,患者认识到,虽然转移性疾病无法治愈,但治疗可以大大降低疾病进展的风险,在以治愈为目的进行治疗的辅助治疗中,目前的治疗方案可降低复发风险。来曲唑在整个乳腺癌治疗过程中的获批为患者提供了许多令人安心的选择。来曲唑在改善治疗结果的同时,并未对整体生活质量产生不利影响。从患者角度来看,潮热、关节痛、阴道干燥以及潜在的骨质疏松等不良事件最为显著,护理人员关注经历这些事件的患者非常重要,因为除非得到有效解释和处理,否则这些事件可能会影响患者的依从性。来曲唑的主要益处在于提高辅助治疗中长期生存的前景,并在转移性疾病治疗中延缓疾病进展以及减少化疗需求。