Barry Mitchel, Kell Malcolm R
Breastcheck, Mater Misericordiae University Hospital, University College Dublin, Dublin, Ireland.
Breast J. 2009 Mar-Apr;15(2):194-8. doi: 10.1111/j.1524-4741.2009.00696.x.
Aromatase inhibitors (AIs) are now regarded as the optimum hormonal therapy for postmenopausal women with hormone receptor positive breast cancer. However, it is unclear which of the currently available AIs offers patients the most effective and the best-tolerated treatment strategy. We performed a systematic review and meta-analysis of randomized-controlled trials that compared AIs (as first-line agents) with standard hormonal treatment in patients with breast cancer. The results suggest that letrozole offers a more favorable side-effect profile particularly in terms of musculoskeletal adverse events. However, the available data suggests a small survival benefit from the use of anastrozole although patients treated with anastrozole appear to have a more favorable disease profile at study entry. Examination of survival data on adjuvant tamoxifen therapy from these trials supports this observation.
芳香化酶抑制剂（AIs）目前被视为激素受体阳性乳腺癌绝经后女性的最佳激素治疗方法。然而，目前尚不清楚哪种现有的AI能为患者提供最有效且耐受性最佳的治疗策略。我们对比较AI（作为一线药物）与标准激素治疗的乳腺癌患者随机对照试验进行了系统评价和荟萃分析。结果表明，来曲唑的副作用情况更为有利，尤其是在肌肉骨骼不良事件方面。然而，现有数据表明，使用阿那曲唑有较小的生存获益，尽管接受阿那曲唑治疗的患者在研究开始时疾病状况似乎更有利。对这些试验中辅助他莫昔芬治疗生存数据的检查支持了这一观察结果。
