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芳香酶抑制剂相关的骨骼和肌肉骨骼影响:新的证据定义病因和管理策略。

Aromatase inhibitor-associated bone and musculoskeletal effects: new evidence defining etiology and strategies for management.

机构信息

Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 1650 Orleans Street, CRBI, Room 144, Baltimore, MD 21231, USA.

出版信息

Breast Cancer Res. 2011 Mar 14;13(2):205. doi: 10.1186/bcr2818.

DOI:10.1186/bcr2818
PMID:21457526
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3219175/
Abstract

Aromatase inhibitors are widely used as adjuvant therapy in postmenopausal women with hormone receptor-positive breast cancer. While the agents are associated with slightly improved survival outcomes when compared to tamoxifen alone, bone and musculoskeletal side effects are substantial and often lead to discontinuation of therapy. Ideally, the symptoms should be prevented or adequately treated. This review will focus on bone and musculoskeletal side effects of aromatase inhibitors, including osteoporosis, fractures, and arthralgias. Recent advances have been made in identifying potential mechanisms underlying these effects. Adequate management of symptoms may enhance patient adherence to therapy, thereby improving breast cancer-related outcomes.

摘要

芳香酶抑制剂被广泛用作激素受体阳性乳腺癌绝经后妇女的辅助治疗。与单独使用他莫昔芬相比,这些药物的生存获益略有改善,但与骨骼和肌肉骨骼相关的副作用显著,且常导致治疗中断。理想情况下,应预防或充分治疗这些症状。本文将重点讨论芳香酶抑制剂的骨骼和肌肉骨骼副作用,包括骨质疏松症、骨折和关节痛。目前已在确定这些作用的潜在机制方面取得了一些进展。充分管理症状可能会提高患者对治疗的依从性,从而改善乳腺癌相关结局。

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本文引用的文献

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Vitamin D threshold to prevent aromatase inhibitor-induced arthralgia: a prospective cohort study.维生素 D 阈值预防芳香化酶抑制剂引起的关节痛:一项前瞻性队列研究。
Breast Cancer Res Treat. 2011 Feb;125(3):869-78. doi: 10.1007/s10549-010-1075-9. Epub 2010 Jul 28.
2
American Society of Clinical Oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer.美国临床肿瘤学会临床实践指南:激素受体阳性乳腺癌患者辅助内分泌治疗的更新。
J Clin Oncol. 2010 Aug 10;28(23):3784-96. doi: 10.1200/JCO.2009.26.3756. Epub 2010 Jul 12.
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Effects of suppression of follicle-stimulating hormone secretion on bone resorption markers in postmenopausal women.抑制卵泡刺激素分泌对绝经后妇女骨吸收标志物的影响。
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Cancer statistics, 2010.癌症统计数据,2010 年。
CA Cancer J Clin. 2010 Sep-Oct;60(5):277-300. doi: 10.3322/caac.20073. Epub 2010 Jul 7.
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Inflammatory cytokines and aromatase inhibitor-associated musculoskeletal syndrome: a case-control study.炎症细胞因子与芳香化酶抑制剂相关的肌肉骨骼综合征:病例对照研究。
Br J Cancer. 2010 Jul 27;103(3):291-6. doi: 10.1038/sj.bjc.6605768. Epub 2010 Jul 6.
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A prospective study of aromatase inhibitor-associated musculoskeletal symptoms and abnormalities on serial high-resolution wrist ultrasonography.一项关于芳香酶抑制剂相关的肌肉骨骼症状和连续高分辨率腕关节超声异常的前瞻性研究。
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