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雌激素拮抗剂他莫昔芬治疗晚期乳腺癌的疗效(作者译)

[Effect of the estrogen antagonist tamoxifen in the treatment of advanced mastocarcinoma (author's transl)].

作者信息

Szepesi T, Kärcher K H

出版信息

Strahlentherapie. 1977 Dec;153(12):832-6.

PMID:341420
Abstract

Today the endocrin therapy of the advanced mastocarcinoma is in common use. Besides the already known therapy by estrogens, androgens, gestagens, and steroids, Tamoxifen, and estrogen antagonist, is a very promising therapeutic drug. In the presented study, Tamoxifen was submitted to a critical clinical control during a period of one year from 1st October 1975 until 1st October 1976. After a three months' treatment, a rate of 41% of objective remissions could be obtained. The criteria of success were estimated according to the scheme of Karnofsky. The average remission time is 5,5 months. By a determination of the estrogen receptors it would be possible to realize a therapeutic selection and to achieve a higher remission rate. The authors made an interesting observation, i.e. a probably immuno-stimulating effect which, however, still has to be submitted to further examinations. The side effects are described in detail and the indications are established. Its is astonishing that the subjective ameliorations, i.e. cessation of pains in case of generalized formation of metastases in the bones are much more frequent than the objective remissions. We came to the conclusion that the treatment by Tamoxifen is a valuable alternative in the therapy of the mastocarcinoma, above all in the postmenopausal period if the disease is advanced and incurable.

摘要

如今,晚期乳腺癌的内分泌治疗已普遍应用。除了已知的雌激素、雄激素、孕激素和类固醇治疗外,雌激素拮抗剂他莫昔芬是一种非常有前景的治疗药物。在本研究中,从1975年10月1日至1976年10月1日的一年时间里,对他莫昔芬进行了严格的临床对照试验。经过三个月的治疗,客观缓解率可达41%。根据卡诺夫斯基方案评估成功标准。平均缓解时间为5.5个月。通过测定雌激素受体,有可能实现治疗选择并获得更高的缓解率。作者有一个有趣的发现,即可能存在免疫刺激作用,不过仍需进一步研究。详细描述了副作用并确定了适应证。令人惊讶的是,主观改善,即在骨转移广泛形成时疼痛停止的情况,比客观缓解更为常见。我们得出结论,他莫昔芬治疗是乳腺癌治疗中的一种有价值的替代方法,尤其是在绝经后期,当疾病进展且无法治愈时。

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