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高剂量氟维司群作为乳腺癌左肾转移的三线内分泌治疗:一例病例报告及文献综述

High-dose fulvestrant as third-line endocrine therapy for breast cancer metastasis to the left kidney: A case report and literature review.

作者信息

Xia Dandan, Wang Huiyu, Wang Runjie, Liu Chaoying, Xu Junying

机构信息

Department of Oncology, Wuxi People's Hospital, Wuxi, P.R. China.

出版信息

Medicine (Baltimore). 2018 Jun;97(24):e11115. doi: 10.1097/MD.0000000000011115.

Abstract

RATIONALE

Endocrine therapy plays an important role in the treatment of patients with hormone receptor-positive breast cancer. Renal metastasis of breast cancer is rare in clinical practice.

PATIENT CONCERNS

We present here a 54-year-old woman with breast cancer after first line chemotherapy and second line endocrinotherapy (i.e., toremifene & exemestane) failure.

DIAGNOSES

The patient was rarely diagnosed breast cancer metastasis to the kidney and a positive hormone status (ER and PR) but was negative for human epidermal factor receptor 2 (HER2).

INTERVENTIONS

The patient was treated with a high dose of fulvestrant (SERD; 500 mg) by intramuscular injection once per month.

OUTCOMES

The patient's condition significantly improved as measured by a decrease in the renal and pulmonary masses; symptoms including dry cough and blood phlegm also improved.

LESSONS

Endocrinotherapy with high-dose fulvestrant may provide benefits for patients with HR+/HER2- advanced breast cancer with renal metastasis after SERMs failure.

摘要

理论依据

内分泌治疗在激素受体阳性乳腺癌患者的治疗中发挥着重要作用。乳腺癌肾转移在临床实践中较为罕见。

患者情况

我们在此介绍一位54岁女性,其在一线化疗和二线内分泌治疗(即托瑞米芬和依西美坦)失败后患有乳腺癌。

诊断

该患者很少被诊断为乳腺癌肾转移且激素状态为阳性(雌激素受体和孕激素受体),但人表皮生长因子受体2(HER2)为阴性。

干预措施

该患者每月接受一次高剂量氟维司群(选择性雌激素受体下调剂;500毫克)肌肉注射治疗。

结果

通过肾脏和肺部肿块缩小来衡量,患者病情显著改善;干咳和血痰等症状也有所改善。

经验教训

对于SERMs治疗失败后发生肾转移的HR+/HER2-晚期乳腺癌患者,高剂量氟维司群内分泌治疗可能有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b76/6023661/eea5be1a484f/medi-97-e11115-g001.jpg

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