Dinger Tessa L, Volders José H, Kuijer Anne, Kelder Johannes C, Doeksen Annemiek, Postma Emily L, van Dalen Thijs
Department of Surgery, St. Antonius Hospital Utrecht, Utrecht, The Netherlands.
Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
Breast Cancer Res Treat. 2025 Sep 12. doi: 10.1007/s10549-025-07809-0.
Endocrine therapy (ET) can be used as a definitive treatment in frail and elderly breast cancer patients who are unwilling or deemed unfit to undergo surgical treatment. This study evaluated the clinical response to ET as primary treatment in elderly patients with non-metastatic, oestrogen receptor (ER) positive breast cancer, by evaluating its effectiveness over time.
Elderly patients (≥ 70 years) with ER-positive breast cancer who had been treated with ET as primary treatment between 2008 and 2015 in two Dutch hospitals were identified through the Netherlands Cancer Registry. The primary outcome was the objectively measured clinical response at various time intervals after initiation of ET.
Out of 122 patients (median age, 86 years), 100 (82%) received ET as definitive treatment, whereas 22 (18%) received ET as neo-adjuvant endocrine therapy. Over the 3-year observation period, 25% of patients had died and 29% underwent invasive local treatment. The overall response rate after 3 years was 14% for all 122 patients and 30% for the 56 patients who were still alive and had not undergone local treatment after 3 years.
The observed clinical response to ET in a consistent proportion of patients over time suggests it may be a viable option for a selection of frail and elderly breast cancer patients with limited life expectancy.
内分泌治疗（ET）可作为不愿或被认为不适合接受手术治疗的体弱老年乳腺癌患者的确定性治疗方法。本研究通过评估ET随时间的有效性，评价其作为老年非转移性雌激素受体（ER）阳性乳腺癌患者一线治疗的临床反应。
通过荷兰癌症登记处确定2008年至2015年期间在两家荷兰医院接受ET作为一线治疗的ER阳性老年乳腺癌患者（≥70岁）。主要结局是ET开始后不同时间间隔客观测量的临床反应。
122例患者（中位年龄86岁）中，100例（82%）接受ET作为确定性治疗，22例（18%）接受ET作为新辅助内分泌治疗。在3年观察期内，25%的患者死亡，29%的患者接受了局部侵入性治疗。122例患者3年后的总缓解率为14%，3年后仍存活且未接受局部治疗的56例患者的总缓解率为30%。
随着时间的推移，观察到一定比例的患者对ET有临床反应，这表明对于预期寿命有限的部分体弱老年乳腺癌患者，ET可能是一种可行的选择。
