Hong Mun-Kun, Chiang Ching-Hsing, Cheng Chiu-Hsuan, Chu Tang-Yuan
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
Am J Case Rep. 2025 Jan 3;26:e946296. doi: 10.12659/AJCR.946296.
BACKGROUND Studies using transgenic mouse models have demonstrated that estrogen is necessary for the development of cervical cancer, particularly in tissues responsive to estrogen. Estrogen also protects cervical cancer cells from apoptosis, suggesting its role in the survival and persistence of cancer cells. CASE REPORT An 84-year-old woman with diabetes mellitus, hypertension, and stage III chronic renal failure was diagnosed with cervical squamous cell carcinoma, FIGO stage IB2. She underwent complete concurrent chemoradiotherapy, but central recurrence was found 9 months later. However, instead of salvage chemotherapy, substitutionary anti-estrogens were given due to her poor medical condition and advanced age. Complete remission was noted after tamoxifen therapy. Since the cervical cancer relapsed again 40 months after tamoxifen use, the anti-estrogen therapy was shifted to letrozole. The SCC-Ag level decreased dramatically after letrozole therapy, and disease stability was achieved until 29 months afterward. After 5 years and 9 months of anti-estrogen use only, the patient died due to noncancer-related pneumonia and heart failure. CONCLUSIONS This report demonstrates the tumor-stabilizing and therapeutic effect of anti-estrogens in the treatment of squamous cervical carcinoma. Further clinical trials are warranted to evaluate the efficacy of anti-estrogen therapy in cervical cancer patients.
使用转基因小鼠模型的研究表明，雌激素对宫颈癌的发生发展是必要的，尤其是在对雌激素有反应的组织中。雌激素还能保护宫颈癌细胞免于凋亡，提示其在癌细胞存活和持续存在中的作用。
一名84岁患有糖尿病、高血压和III期慢性肾衰竭的女性被诊断为宫颈鳞状细胞癌，国际妇产科联盟（FIGO）分期为IB2期。她接受了同步放化疗，但9个月后发现中心复发。然而，由于她身体状况差且年龄较大，未进行挽救性化疗，而是给予了替代抗雌激素药物。他莫昔芬治疗后达到完全缓解。由于使用他莫昔芬40个月后宫颈癌再次复发，抗雌激素治疗改为来曲唑。来曲唑治疗后鳞状细胞癌抗原（SCC-Ag）水平显著下降，直至29个月后病情保持稳定。仅使用抗雌激素药物5年9个月后，患者因非癌症相关的肺炎和心力衰竭死亡。
本报告证明了抗雌激素药物在治疗宫颈鳞状细胞癌中的肿瘤稳定和治疗作用。有必要进行进一步的临床试验以评估抗雌激素治疗对宫颈癌患者的疗效。
