Drăgănescu Mădălina, Carmocan Codruţa
Chirurgia (Bucur). 2017 Jul-Aug;112(4):413-417. doi: 10.21614/chirurgia.112.4.413.
Hormonal therapy is mandatory for all patients with hormonereceptor- positive breast neoplasms. It is active both in adjuvant and metastatic disease. The only active adjuvant hormonal therapy in pre- and postmenopause is Tamoxifen. The adjuvant treatment duration influences disease-free survival, the risk of a contralateral breast cancer apparition and overall survival. The aromatase inhibitors: Anastrozol, Letrozol, Exemestan are only used in postmenopause. Fulvestrant is used in recurrent disease after or during treatment with Tamoxifen. LHRH analogues are used in premenopausal patients in adjuvantcy and sometimes in case of recurrences. Around 50% of hormonereceptor- positive breast neoplasms are or become resistant to hormone therapy. Some molecules involved in some tumour cellular growth pathways reverse the resistance to hormone therapy (Palbociclib, Everolimus).
激素治疗对于所有激素受体阳性的乳腺肿瘤患者来说是必不可少的。它在辅助治疗和转移性疾病中均有作用。绝经前后唯一有效的辅助激素治疗药物是他莫昔芬。辅助治疗的持续时间会影响无病生存期、对侧乳腺癌出现的风险以及总生存期。芳香化酶抑制剂：阿那曲唑、来曲唑、依西美坦仅用于绝经后患者。氟维司群用于他莫昔芬治疗后或治疗期间复发的疾病。促性腺激素释放激素类似物用于绝经前患者的辅助治疗，有时也用于复发情况。大约50%的激素受体阳性乳腺肿瘤对激素治疗存在或会产生耐药性。一些参与某些肿瘤细胞生长途径的分子可逆转对激素治疗的耐药性（帕博西尼、依维莫司）。
