Szepesi T, Czech W
Wien Klin Wochenschr. 1978 Feb 17;90(4):133-41.
The endocrine management of advanced breast cancer is of great clinical importance. Apart from the known therapeutic approach with oestrogens, androgens, gestagens and steroids, the oestrogen antagonist, tamoxifen appears to be a promising therapeutic agent. In this study from October 1st, 1975, to October 1st, 1976, the value of tamoxifen was examined in a controlled clinical trial. An objective remission after 3 months' treatment was achieved in 41% of the cases. The criteria of Karnofsky were used to evaluate clinical success. The median time of remission was 5,5 months. The determination of oestrogen receptors could provide a better selection of patients and, hence, help to achieve an increase in the remission rate. An interesting observation was a probably immunostimulative effect, but further investigations are necessary. The side-effects of treatment are detailed and the indications for the use of tamoxifen are discussed. More astonishing than the objective remission was the subjective improvement with relief of pain due to generalized bone metastases. On the basis of our observations it is concluded, that the use of the oestrogen antagonist, tamoxifen presents a potent alternative in the treatment of advanced and incurable breast cancer, especially in postmenopausal patients.