Johnson P A, Bonomi P D, Anderson K M, Wolter J M, Economou S G
Semin Oncol. 1986 Dec;13(4 Suppl 4):15-9.
Megestrol acetate as initial hormonal therapy produced a 40% objective response rate in 53 patients with advanced breast cancer; another 26% achieved stable disease. For 19 patients with visceral-dominant disease, the response rate was 42%. To investigate the effect of the order of sequential hormonal therapy, records of 66 patients treated with tamoxifen before megestrol acetate or with megestrol acetate before tamoxifen were reviewed retrospectively. Of the 24 patients who were given megestrol acetate first, nine (38%) had objective response to primary therapy, and four (17%) to secondary therapy. Among the 42 patients treated with tamoxifen first, there were nine (21%) objective responses to primary therapy and eight (19%) responses to secondary therapy. Results show that megestrol acetate is effective first-line hormonal therapy for advanced breast cancer. Megestrol acetate can be used as primary hormonal therapy and tamoxifen as secondary hormonal therapy, as an alternative to the more usual reverse order. One may also consider megestrol acetate for some advanced breast cancer patients with visceral-dominant disease.
醋酸甲地孕酮作为初始激素疗法，在53例晚期乳腺癌患者中产生了40%的客观缓解率；另有26%的患者病情稳定。对于19例以内脏转移为主的患者，缓解率为42%。为了研究序贯激素疗法顺序的影响，回顾性分析了66例在醋酸甲地孕酮之前接受他莫昔芬治疗或在他莫昔芬之前接受醋酸甲地孕酮治疗的患者记录。在24例首先给予醋酸甲地孕酮的患者中，9例（38%）对初始治疗有客观缓解，4例（17%）对二线治疗有客观缓解。在42例首先接受他莫昔芬治疗的患者中，9例（21%）对初始治疗有客观缓解，8例（19%）对二线治疗有客观缓解。结果表明，醋酸甲地孕酮是晚期乳腺癌有效的一线激素疗法。醋酸甲地孕酮可作为初始激素疗法，他莫昔芬作为二线激素疗法，这是更常用顺序的替代方案。对于一些以内脏转移为主的晚期乳腺癌患者，也可以考虑使用醋酸甲地孕酮。
