Sauter C
Departement für Innere Medizin, Universitätsspital Zürich.
Praxis (Bern 1994). 1995 Jun 13;84(24):713-7.
Endocrine treatments of breast cancer patients play an important role in the management of this common tumor of women. In this short review the most frequently applied drugs are discussed; thereafter, their use is shown in the curative (adjuvant) and in the palliative situation. In premenopausal women who suffer from a hormone-sensitive cancer, adjuvant treatments include either ovarian ablation or adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-fluoro-uracil. In post-menopausal women, the adjuvant treatment of choice is tamoxifen. The currently active protocols for adjuvant treatments of hormone-sensitive breast cancers of the International Breast Cancer Study Group (IBCSG) and the Swiss Group for Clinical Cancer Research (SAKK) should not be followed because of the anthracyclines administered to a high percentage of the involved patients. These drugs, known for their cardiotoxic side effects, have for the time being no place in the adjuvant treatment of hormone-sensitive breast cancers; therefore, the duty of the primary-care physician is to protect his patients from these protocols. In the palliative treatment, tamoxifen is the first choice. The success of this treatment is shown by a few examples.
乳腺癌患者的内分泌治疗在这种常见的女性肿瘤管理中发挥着重要作用。在这篇简短的综述中,将讨论最常用的药物;随后,展示它们在根治性(辅助性)和姑息性治疗中的应用。对于患有激素敏感性癌症的绝经前女性,辅助治疗包括卵巢去势或使用环磷酰胺、甲氨蝶呤和5-氟尿嘧啶进行辅助化疗。对于绝经后女性,首选的辅助治疗药物是他莫昔芬。国际乳腺癌研究组(IBCSG)和瑞士临床癌症研究组(SAKK)目前用于激素敏感性乳腺癌辅助治疗的方案不应采用,因为参与研究的患者中有很大比例使用了蒽环类药物。这些药物以其心脏毒性副作用而闻名,目前在激素敏感性乳腺癌的辅助治疗中没有立足之地;因此,初级保健医生的职责是保护其患者不采用这些方案。在姑息治疗中,他莫昔芬是首选。通过一些实例展示了这种治疗的成效。