Allegra J C
Semin Hematol. 1987 Apr;24(2 Suppl 1):45-7.
Breast cancer is either hormone independent or hormone dependent. Hormone-dependent tumors are responsive to hormonal manipulation about 80% of the time, because their cells contain specific steroid hormone receptors that bind to the hormone. Tumors lacking these receptors demonstrate response rates of less than 10%, and patients with such tumors are not candidates for hormonal therapy. Additive hormonal therapy, which lacks the morbidity and mortality of ablative procedures, is reversible, and does not require life-long replacement therapy, has replaced many of the ablative procedures. A recent, randomized, prospective, controlled clinical trial compared megestrol acetate and tamoxifen in 197 postmenopausal women with metastatic breast cancer. Efficacy, as measured by response rate and duration of remission, was equal in both groups. Moreover, each agent was associated with little toxicity. As women with stages I and II operable breast cancer have recurrences of their tumors after exposure to antiestrogen therapy, it is practical to consider treatment with megestrol acetate, whose mechanism of action of killing tumor cells may be different from that of tamoxifen.
乳腺癌要么是激素非依赖性的，要么是激素依赖性的。激素依赖性肿瘤约80%的情况下对激素操纵有反应，因为其细胞含有与激素结合的特定类固醇激素受体。缺乏这些受体的肿瘤显示出低于10%的反应率，患有此类肿瘤的患者不是激素治疗的候选对象。缺乏消融手术的发病率和死亡率、具有可逆性且不需要终身替代治疗的辅助激素治疗，已经取代了许多消融手术。最近一项随机、前瞻性、对照临床试验，在197名患有转移性乳腺癌的绝经后妇女中比较了醋酸甲地孕酮和他莫昔芬。以反应率和缓解持续时间衡量的疗效，在两组中是相同的。此外，每种药物的毒性都很小。由于I期和II期可手术乳腺癌患者在接受抗雌激素治疗后会出现肿瘤复发，考虑用醋酸甲地孕酮进行治疗是可行的，其杀死肿瘤细胞的作用机制可能与他莫昔芬不同。
