Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ann Oncol. 2012 Jun;23(6):1471-4. doi: 10.1093/annonc/mdr459. Epub 2011 Nov 15.
Approximately 2000 American men are diagnosed with breast cancer every year. Limited data are available evaluating toxicity of antihormonal treatments in male breast cancer patients.
We reviewed male breast cancer patients evaluated at our institution (1999-2009). Of 126 patients, 64 met the following inclusion criteria: stage I-III, treated with tamoxifen, at least one follow-up visit after starting tamoxifen. A descriptive analysis of toxic effects was carried out on these 64 patients.
Median follow-up from start of tamoxifen therapy was 3.9 years (range 0.3-19.4 years). Median age at diagnosis was 61 years (range 30-79 years). Breakdown by stage: 29.7% (n = 19) stage I, 54.7% (n = 35) stage II, and 15.6% (n = 10) stage III. Thirty-four (53%) patients experienced one or more toxicity while taking tamoxifen. Most common toxic effects are weight gain (14 patients, 22%) and sexual dysfunction (14 patients, 22%). Thirteen (20.3%) patients discontinued tamoxifen due to toxicity: one ocular, one leg cramps, two neurocognitive deficits, two bone pain, three sexual dysfunction, and four thromboembolic events.
To our knowledge, this is the largest study examining tamoxifen-related toxic effects among male breast cancer patients. Among male patients, there is a high rate of discontinuation of tamoxifen. Prospective studies of antihormonal agents in male breast cancer are warranted.
每年约有 2000 名美国男性被诊断患有乳腺癌。目前评估男性乳腺癌患者抗激素治疗毒性的数据有限。
我们回顾了在我院评估的男性乳腺癌患者(1999-2009 年)。在 126 名患者中,64 名符合以下纳入标准:I-III 期,接受他莫昔芬治疗,在开始他莫昔芬治疗后至少有一次随访。对这 64 名患者的毒性作用进行了描述性分析。
从他莫昔芬治疗开始的中位随访时间为 3.9 年(范围 0.3-19.4 年)。诊断时的中位年龄为 61 岁(范围 30-79 岁)。分期情况:29.7%(n=19)为 I 期,54.7%(n=35)为 II 期,15.6%(n=10)为 III 期。34 名(53%)患者在服用他莫昔芬时出现一种或多种毒性。最常见的毒性作用是体重增加(14 例,22%)和性功能障碍(14 例,22%)。由于毒性,13 名(20.3%)患者停止服用他莫昔芬:1 例眼部,1 例腿部痉挛,2 例认知功能障碍,2 例骨痛,3 例性功能障碍,4 例血栓栓塞事件。
据我们所知,这是研究男性乳腺癌患者他莫昔芬相关毒性作用的最大研究。在男性患者中,停止服用他莫昔芬的比例很高。有必要对男性乳腺癌的抗激素药物进行前瞻性研究。