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JCO:他莫昔芬加卵巢功能抑制治疗能更好控制乳腺癌

2016-03-31 zhaozhou 译 MedSci原创

 最近发布的两项临床试验——他莫昔芬和依西美坦试验(TEXT)和卵巢功能抑制试验(SOFT)的临床结果为治疗绝经前有内分泌反应性早期乳腺癌的妇女提供了新的选择。SOFT试验中,他莫昔芬加上卵巢功能抑制(OFS)相对于单独使用他莫昔芬可以改善疾病控制,从而使得绝经前的妇女可以得到更好的化疗。SOFT试验的研究人员因此报道了由病人报告的疾病结局。为今后治疗这一类病人提供依据。 生活

最近发布的两项临床试验——他莫昔芬和依西美坦试验(TEXT)和卵巢功能抑制治疗试验(SOFT)的临床结果为治疗绝经前有内分泌反应性的早期乳腺癌的妇女提供了新的选择。SOFT试验中,相对于单独使用他莫昔芬,他莫昔芬加上卵巢功能抑制(OFS)可以改善疾病控制,从而使得绝经前的妇女可以得到更好的化疗。SOFT试验的研究人员因此报道了由病人报告的疾病结局。为今后治疗这一类病人提供依据。

 
生活质量分析包括了2045名处于绝经前的激素受体阳性乳腺癌患者中的1722名患者。这些患者被随机分组,接受为期五年的辅助治疗。治疗方案分别诶他莫昔芬加OFS或者单独使用他莫昔芬。在召集受试者之前使用化疗是可选的。患者要填写一份生活质量表格,这份表格涵盖了基线时期的整体和症状指示。检测6、24和60个月时的从基线时生活质量的改变的差异。

接受他莫昔芬加OFS治疗的患者在6和24个月时比单独接受他莫昔芬治疗的患者更容易受到潮红的影响,在六个月的时候更容易受到丧失性欲和睡眠障碍的影响,并且直到60个月的时候会受到引道干涩的影响。先前没有接受过化疗,单独使用他莫昔芬的患者相对于他莫昔芬加OFS的患者有着更多的阴道分泌物。先前接受过化疗的患者更少报告有在六个月时的症状特异性治疗差异。
 
总体来说,他莫昔芬加上OFS,在治疗的头两年会导致更差内分泌症状以及性功能下降。但是对于疾病控制来说,OFS有一定的益处。

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    2016-12-21 lidong40
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先前有研究表明他莫昔芬可降低乳腺癌复发风险,但是同时使用抗抑郁药物是否会干扰到他莫昔芬的有效性?就该问题目前并没有统一的答案。因此研究者进行了一项研究,调查同时服用他莫昔芬和抗抑郁药物(特别是帕罗西汀)是否会增加复发或对侧乳腺癌风险。该研究纳入了16887名0-Ⅱ期使用他莫昔芬治疗的乳腺癌生存者,以他莫昔芬和抗抑郁药物(帕罗西汀、氟西汀、其他选择性5-羟色胺再摄取抑制剂、三环类和其他)重叠百分比

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