Chlebowski Rowan T
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, Building J-3, Torrance, CA 90502, USA.
Breast. 2008 Apr;17 Suppl 3:S9-15. doi: 10.1016/j.breast.2007.12.003.
Tamoxifen has been the standard first-line adjuvant treatment for postmenopausal women with early breast cancer for over 3 decades. Its use, however, is associated with a number of potentially life-threatening adverse events. As a result, the aromatase inhibitors (AIs), which are generally better tolerated and more efficacious, are now beginning to supersede tamoxifen as the treatment of choice in this setting. Nevertheless, some patients in clinical practice still start or remain on tamoxifen therapy instead of an AI. This review investigates our current understanding of AIs and tamoxifen in the adjuvant hormonal therapy of postmenopausal breast cancer in relation to efficacy, safety and patient benefits. Overall, it is concluded that the AIs show a significant advantage over tamoxifen, with the greatest difference observed at 1-2 years after initiation of treatment. Therefore, using an AI at the earliest opportunity provides patients with the best option to prevent the recurrence and excess adverse events associated with tamoxifen.
三十多年来，他莫昔芬一直是绝经后早期乳腺癌女性的标准一线辅助治疗药物。然而，其使用与一些潜在的危及生命的不良事件相关。因此，芳香化酶抑制剂（AIs）通常耐受性更好且更有效，现在已开始取代他莫昔芬成为这种情况下的首选治疗方法。尽管如此，临床实践中的一些患者仍开始或继续使用他莫昔芬治疗而非芳香化酶抑制剂。本综述探讨了我们目前对芳香化酶抑制剂和他莫昔芬在绝经后乳腺癌辅助激素治疗中关于疗效、安全性和患者获益方面的理解。总体而言，得出的结论是，芳香化酶抑制剂比他莫昔芬具有显著优势，在开始治疗后的1至2年观察到最大差异。因此，尽早使用芳香化酶抑制剂为患者提供了预防与他莫昔芬相关的复发和额外不良事件的最佳选择。
