Rose C
Department of Oncology R, Odense University Hospital, Denmark.
Acta Oncol. 1990;29(3):361-5. doi: 10.3109/02841869009090015.
Recent research has produced several new options for endocrine treatment of metastatic breast cancer. Among these, tamoxifen has become the most commonly used endocrine therapy for metastatic breast cancer due to its few side effects and an overall response rate of 35%. Despite an obvious clinical rationale for combined endocrine therapy, most trials have failed to show any benefit. Although data from trials combining tamoxifen with prednisolone or androgens seem promising, the use of combined endocrine therapy still has to be considered experimental. In patients with metastatic breast cancer, a combination of cytotoxic and endocrine therapy generally leads to a higher rate of remission than in patients treated with either modality alone. The increase in rate of response, however, is not followed by an increase in survival. The combined approach should therefore be explored further in randomized trials, preferably based upon a better understanding of tumor cell kinetics.
最近的研究为转移性乳腺癌的内分泌治疗带来了几种新选择。其中，他莫昔芬因其副作用少且总体缓解率达35%，已成为转移性乳腺癌最常用的内分泌治疗药物。尽管联合内分泌治疗有明确的临床依据，但大多数试验均未显示出任何益处。虽然他莫昔芬与泼尼松龙或雄激素联合治疗的试验数据似乎很有前景，但联合内分泌治疗的应用仍被视为实验性的。在转移性乳腺癌患者中，细胞毒性药物与内分泌治疗联合应用通常比单独使用任何一种治疗方式的缓解率更高。然而，缓解率的提高并未带来生存率的增加。因此，应在随机试验中进一步探索联合治疗方法，最好是在对肿瘤细胞动力学有更好理解的基础上进行。
