Assikis V J, Neven P, Jordan V C, Vergote I
Robert H. Lurie Cancer Center, Northwestern University Medical School, Chicago Illinois, USA.
Eur J Cancer. 1996 Aug;32A(9):1464-76. doi: 10.1016/0959-8049(96)00184-0.
Tamoxifen has been the endocrine treatment of choice for all stages of breast cancer for nearly a decade. Millions of women are currently receiving tamoxifen worldwide, while large-scale randomised trials have been launched aiming to investigate the drug's merit as a preventive agent. However, there are now concerns about tamoxifen's potential carcinogenicity. The goal of this review is to address these concerns, re-evaluate the available data from laboratory biological models and those from clinical reports and put the whole issue into perspective. Our focus is the association between tamoxifen and the increased frequency of endometrial tumours, while key issues, such as the role of duration of tamoxifen therapy, are also addressed. Finally, we discuss the various monitoring strategies for early detection of endometrial lesions and pertinent problems most likely to be encountered by clinicians taking care of patients who are receiving tamoxifen.
近十年来，他莫昔芬一直是乳腺癌各阶段内分泌治疗的首选药物。目前全球有数百万女性正在接受他莫昔芬治疗，同时已开展大规模随机试验，旨在研究该药物作为预防剂的优点。然而，现在人们对他莫昔芬的潜在致癌性表示担忧。本综述的目的是解决这些担忧，重新评估来自实验室生物学模型和临床报告的现有数据，并全面看待整个问题。我们关注的是他莫昔芬与子宫内膜肿瘤发病率增加之间的关联，同时也讨论了他莫昔芬治疗持续时间的作用等关键问题。最后，我们讨论了子宫内膜病变早期检测的各种监测策略，以及照顾接受他莫昔芬治疗患者的临床医生最可能遇到的相关问题。
