Academic Trials Promoting Team, Jules Bordet Institute and Université Libre de Bruxelles, Brussels, Belgium.
Academic Trials Promoting Team, Jules Bordet Institute and Université Libre de Bruxelles, Brussels, Belgium; Medical Oncology and Hematology Unit, IRCCS Istituto Clinico Humanitas-Humanitas Cancer Center, Humanitas Research Hospital, Milan, Italy.
Lancet Oncol. 2021 Jul;22(7):e303-e313. doi: 10.1016/S1470-2045(20)30666-5. Epub 2021 Apr 20.
The growing availability of more effective therapies has contributed to an increased survival of patients with breast cancer. In hormone receptor-positive early disease, increased survival is strongly correlated with the use of adjuvant endocrine therapy, but this therapy can cause side-effects that have major consequences in terms of treatment adherence and patients' quality of life. In premenopausal breast cancer survivors, these side-effects might be even more prominent due to the abrupt suppression of oestrogen associated with the most intense endocrine therapies. An important ambition of cancer care in the 21st century is to recover pre-cancer quality of life and emotional and social functions, which is only possible through the mitigation of the side-effects of anticancer treatments. This Review presents a comprehensive summary of the efficacy and safety data of the available interventions (hormonal and non-hormonal pharmacological strategies, non-pharmacological approaches, and complementary and alternative medicine) to control selected side-effects associated with adjuvant endocrine therapy (hot flashes, sexual dysfunction, weight gain, musculoskeletal symptoms, and fatigue), providing updated, evidence-based approaches for their management.
越来越多有效的治疗方法的出现，使得乳腺癌患者的生存率得到提高。在激素受体阳性的早期疾病中，辅助内分泌治疗的使用与生存率的提高密切相关，但这种治疗会引起副作用，对治疗的依从性和患者的生活质量产生重大影响。在绝经前乳腺癌幸存者中，由于最强烈的内分泌治疗会突然抑制雌激素，这些副作用可能更为明显。21 世纪癌症治疗的一个重要目标是恢复癌症前的生活质量和情感及社会功能，这只有通过减轻抗癌治疗的副作用才能实现。这篇综述全面总结了现有干预措施（激素和非激素药物治疗策略、非药物方法以及补充和替代医学）在控制辅助内分泌治疗相关副作用（热潮红、性功能障碍、体重增加、肌肉骨骼症状和疲劳）方面的疗效和安全性数据，为其管理提供了最新的循证方法。
