Manni A, Pearson O H
Cancer Treat Rep. 1980 Jun-Jul;64(6-7):779-85.
Tamoxifen (T) was given in doses of 40-120 mg/day to 11 premenopausal women with stage IV breast cancer. Objective remission occurred in five, the disease did not progress in one, and five failed to respond. Duration of remission is 19+ months. Five patients underwent ovariectomy after receiving T: of two who responded to T and then relapsed, one responded to ovariectomy; three who failed to benefit from T also failed to improve after ovariectomy. The effect of T on the menstrual cycle ranged from no effect to complete cessation of menses, usually observed in patients who received larger doses. T induced a marked rise in serum estrone and estradiol, reaching levels up to 2500 pg/ml; serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels remained in the normal premenopausal range or were slightly elevated. In two patients in whom amenorrhea was induced with larger doses of T, both serum estrogen and gonadotropin levels were elevated. We conclude that T is effective in treating premenopausal patients with stage IV breast cancer. Because of the stimulating effect of T on ovarian function. escalated doses of T or castration plus T may be necessary in those patients who respond to T.
对11例IV期乳腺癌绝经前女性患者给予剂量为40 - 120毫克/天的他莫昔芬（T）。5例出现客观缓解，1例疾病未进展，5例无反应。缓解持续时间为19 +个月。5例患者在接受T治疗后进行了卵巢切除术：在2例对T有反应后复发的患者中，1例对卵巢切除术有反应；3例未从T中获益的患者在卵巢切除术后也未改善。T对月经周期的影响从无影响到完全停经不等，通常在接受较大剂量的患者中观察到。T可使血清雌酮和雌二醇显著升高，达到高达2500 pg/ml的水平；血清促卵泡生成素（FSH）和促黄体生成素（LH）水平保持在绝经前正常范围内或略有升高。在2例因大剂量T导致闭经的患者中，血清雌激素和促性腺激素水平均升高。我们得出结论，T对治疗IV期乳腺癌绝经前患者有效。由于T对卵巢功能有刺激作用，对于对T有反应的患者，可能需要增加T的剂量或进行去势加T治疗。
