他莫昔芬治疗芳香化酶抑制剂耐药的激素受体阳性绝经后转移性乳腺癌患者的临床研究

Clinical observation of tamoxifen in hormone receptor- positive postmenopausal patients with metastatic breast cancer failing to Aromatase inhibitors

目的:探讨他莫昔芬治疗芳香化酶抑制剂(AIs)耐药的激素受体阳性(HR+)绝经后转移性乳腺癌(MBC)患者的疗效和安全性。方法:回顾性分析他莫昔芬治疗AIs耐药的30例HR+绝经后MBC患者的临床资料,观察终点为缓解率(RR)、临床获益率(CBR)、疾病进展时间(TTP)和安全性。结果:30例患者中,CR1例,PR 9例,SD 15例,RR为33.3%,CBR为50%,中位TTP 6.1个月。23例骨和/或软组织转移患者中,RR为34.8%,CBR为52.2%,中位TTP 7.3个月;7例肝脏和/或肺部转移患者中,RR为28.6%,CBR为42.8%,中位TTP 4.8个月(P=0.019)。不良反应多为面部潮红、阴道干燥、白带增多、阴道出血、恶心、呕吐、腹泻等,均为I、II级。结论:他莫昔芬治疗AIs耐药的HR+绝经后MBC患者安全有效,可改善患者预后。

Objective： To investigate the curative effect and safety of tamoxifen in hormone receptor- positive（ HR＋） postmenopausal patients with metastatic breast cancer（ MBC） failing to Aromatase inhibitors（ AIs）. Methods： Retrospectively analyzed clinical data of 30 patients with HR＋postmenopausal MBC treated with tamoxifen after AIs resistance. The endpoints were response rate（ RR）,clinical benefit rate（ CBR）,time of tumor progression（ TTP）and safety. Results： In 30 patients,the patients who acquired CR,PR and SD were 1,9 and 15. The RR and CBR were33. 3% and 50%. The median TTP was 6. 1 months. The RR and CBR in 23 cases with bone and / or soft tissue metastasis and 7 cases of liver and / or pulmonary metastasis were 34. 8%,52. 2% and 28. 6%,42. 8%. The median TTP were 7. 3 and 4. 8 months in two groups（ P = 0. 019）. The most common adverse reactions were hot flashes,vaginal dryness,vaginal discharge,vaginal bleeding,nausea,vomiting,diarrhea and so on. Most side effects were grade Ⅰ orⅡ on the WHO scale. Conclusion： Treatment with tamoxifen in AIs resistant HR＋postmenopausal patients with MBC is safe and effective,can improve prognosis of patients.