Akhtar S S, Allan S G, Rodger A, Chetty U D, Smyth J F, Leonard R C
University Department of Clinical Oncology, Western General Hospital, Edinburgh, Scotland, UK.
Eur J Surg Oncol. 1991 Feb;17(1):30-5.
Between 1977 and 1983 100 elderly women (median 76.3 years) with breast cancer were treated with tamoxifen as primary therapy. The median follow-up is 59 months. Sixty-eight responded (40 CR and 28 PR) with median response durations of 47 months and 26 months respectively. Twenty-two patients had disease stabilization for a median of 15.5 months and 10 had progressive disease. The median time to best response was 13.5 weeks for patients achieving CR and 14 weeks for those with PR. Oestrogen receptor values were obtained in 37 patients of which two patients had no ER detectable. Sixty-seven per cent of ER-unknown patients responded compared with 74% of ER-rich. Likelihood of response did not appear to depend upon T-stage or age. Survival was better than that of an unmatched historical group treated with surgery/radiotherapy and compares favourably with recent reports. Although 35% have died of breast cancer, 25% died of other causes and 22% remained free of recurrence at the time of reporting or at death. Only 11% underwent subsequent mastectomy/lumpectomy and the most frequent subsequent treatments were radiotherapy to the breast (32%) and further hormonal therapies (40%). Tamoxifen is a practical primary therapy of breast cancer in elderly and frail women obviating the need for surgery in a high proportion of cases.
1977年至1983年间，100名老年女性（年龄中位数76.3岁）乳腺癌患者接受他莫昔芬作为初始治疗。中位随访时间为59个月。68例有反应（40例完全缓解和28例部分缓解），完全缓解和部分缓解的中位反应持续时间分别为47个月和26个月。22例患者病情稳定，中位时间为15.5个月，10例病情进展。达到完全缓解的患者最佳反应的中位时间为13.5周，部分缓解的患者为14周。37例患者检测了雌激素受体值，其中2例未检测到雌激素受体。雌激素受体情况未知的患者中有67%有反应，雌激素受体丰富的患者中有74%有反应。反应可能性似乎不取决于肿瘤分期或年龄。生存率优于未匹配的接受手术/放疗的历史对照组，与近期报告相比也较好。虽然35%的患者死于乳腺癌，但25%死于其他原因，22%在报告时或死亡时仍无复发。仅11%的患者随后接受了乳房切除术/肿块切除术，最常见的后续治疗是乳房放疗（32%）和进一步的激素治疗（40%）。他莫昔芬是老年体弱女性乳腺癌的一种实用初始治疗方法，在很大比例的病例中无需手术。
