Rosell Johan, Nordenskjöld Bo, Bengtsson Nils-Olof, Fornander Tommy, Hatschek Thomas, Lindman Henrik, Malmström Per-Olof, Wallgren Arne, Stål Olle, Carstensen John
a Regional Cancer Center South East Sweden , Linköping , Sweden.
b Oncology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences , Linköping University , Linköping , Sweden.
Acta Oncol. 2017 Apr;56(4):614-617. doi: 10.1080/0284186X.2016.1273547. Epub 2017 Jan 12.
Tamoxifen is a well established treatment for breast cancer, but its long-term effects on the incidence of secondary cancers are not fully evaluated.
We have studied 4128 postmenopausal patients with early stage breast cancer who were alive and free of breast cancer recurrence after two years of tamoxifen, and who were randomized to receive totally two or five years of therapy.
Compared to patients randomized to two years of tamoxifen the incidence of contralateral breast cancer [hazard ratio (HR) 0.73; 95% CI 0.56-0.96] and of lung cancer (HR 0.45; 95% CI 0.27-0.77), especially squamous cell and small cell lung cancer, were reduced in the five-year group, and similar results were seen when restricting the analysis to the 10-year period after treatment stopped. An increased incidence of endometrial cancer was observed in the five-year group, but the excess risk decreased over time.
Further studies of the effects of tamoxifen on the risk of different histological types of lung cancer are needed.
他莫昔芬是一种成熟的乳腺癌治疗药物，但其对继发性癌症发病率的长期影响尚未得到充分评估。
我们研究了4128例绝经后早期乳腺癌患者，这些患者在接受两年他莫昔芬治疗后存活且无乳腺癌复发，并被随机分配接受总共两年或五年的治疗。
与随机接受两年他莫昔芬治疗的患者相比，五年治疗组对侧乳腺癌的发病率[风险比（HR）0.73；95%置信区间0.56 - 0.96]和肺癌的发病率（HR 0.45；95%置信区间0.27 - 0.77），尤其是鳞状细胞癌和小细胞肺癌的发病率降低，并且在停止治疗后的10年期间进行分析时也观察到了类似结果。五年治疗组子宫内膜癌的发病率有所增加，但额外风险随时间降低。
需要进一步研究他莫昔芬对不同组织学类型肺癌风险的影响。
