Division of Genitourinary Malignancies, Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA.
Maturitas. 2010 Nov;67(3):209-14. doi: 10.1016/j.maturitas.2010.07.004. Epub 2010 Aug 4.
Endocrine therapy in the setting of breast cancer has undoubtedly advanced clinical outcomes in this disease, but treatment with endocrine therapy is accompanied by a wide spectrum of side effects. It is of prime importance to understand and characterize these toxicities to facilitate clinical decision-making. Somewhat surprisingly, there is a relative paucity of data pertaining to cognitive changes associated with endocrine therapy. In this article we review cognitive associated with two classes of endocrine therapy: (1) selective estrogen receptor modulators (SERMs; tamoxifen and raloxifene) and (2) aromatase inhibitors (AIs; anastrozole, letrozole, and exemestane). Companion studies to the Multiple Outcome of Raloxifene Evaluation (MORE), the Study of Tamoxifen and Raloxifene (STAR) and National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 trials provide relevant data to understand the effect of SERMs on cognition. In contrast, substudies of the Arimidex, Tamoxifen Alone or in Combination (ATAC), Tamoxifen and Exemestane Adjuvant Multinational (TEAM) and Breast International Group (BIG) 1-98 trials juxtapose cognitive effects of AIs against those of tamoxifen. These and other studies are examined herein to provide a comprehensive overview of the effect of endocrine therapy on cognition.
在乳腺癌的治疗中，内分泌治疗无疑提高了临床疗效，但内分泌治疗也伴随着广泛的副作用。了解和描述这些毒性作用对于临床决策至关重要。令人惊讶的是，与内分泌治疗相关的认知变化的数据相对较少。本文综述了两类内分泌治疗药物相关的认知问题：（1）选择性雌激素受体调节剂（SERMs；他莫昔芬和雷洛昔芬）和（2）芳香化酶抑制剂（AIs；阿那曲唑、来曲唑和依西美坦）。与多柔比星相关的瑞洛昔芬评估（MORE）、他莫昔芬和雷洛昔芬研究（STAR）和全国外科辅助乳腺和肠项目（NSABP）P-1 试验的伴随研究提供了相关数据，以了解 SERMs 对认知的影响。相比之下，阿那曲唑、他莫昔芬单独或联合（ATAC）、他莫昔芬和依西美坦辅助多国（TEAM）和乳腺国际集团（BIG）1-98 试验的亚研究将 AI 的认知影响与他莫昔芬进行了对比。本文对这些和其他研究进行了检查，以提供内分泌治疗对认知影响的全面概述。
