托瑞米芬与来曲唑在老年乳腺癌术后内分泌治疗中的疗效比较

Clinical Effects of Toremifene and Letrozole on Elderly Late Breast Cancer Patients Undergoing Endocrine Therapy

【目的】比较托瑞米芬与芳香化酶抑制剂来曲唑在老年乳腺癌患者术后内分泌治疗中的临床疗效。【方法】按照随机数字表法，将100例晚期老年乳腺癌患者分为对照组和观察组，每组50例。乳腺癌切除术后，对照组给予口服托瑞米芬，观察组给予口服来曲唑。比较所有患者治疗前后Kupperman评分、KPS评分，两组患者治疗前后高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、三酰甘油（TG）水平。记录并比较两组患者临床病理特点。【结果】治疗后，对照组和观察组患者的Kupperman评分与治疗前均有显著统计学差异（均P〈O．05）。治疗后，观察组患者的KPS评分明显高于治疗前（P〈0．05），与对照组相比，研究组患者的KPS评分明显升高（P〈0．05）。治疗后，对照组HDL-C显著增高（P〈0．05），LDL-C、TC显著降低（P〈0．05），TG无明显变化（P〉0．05）；观察组患者的血脂水平均低于治疗前（均P〈0．05）；观察组患者的血清HDL-C、LDL-C、TC、TG显著低于对照组患者（P〈0．05）。对照组和观察组合并症、肿瘤发生部位、腋窝淋巴结转移、接受化疗、化疗耐受性比较，差异均无统计学意义（均P〉0．05）；内分泌药物依从性和门诊定期复诊率比较具有显著统计学差异（P〈0．05）。【结论】与托瑞米芬相比，来曲唑可显著改善老年乳腺癌患者的临床症状，提高生活质量，降低血脂水平，具有更好的药物依从性和门诊定期复诊率。

[Objective] To investigate and compare the clinical effects of toremifene and letrozole-an aro- matase inhibitor on elderly late breast cancer patients undergoing endocrine therapy. [Methods] According to the random number table, 100 elderly patients with late breast cancer were equally divided into control group and research group. After surgery, the control group took toremifene, and the research group took letrozole （a kind of aromatase inhibitor） every day. Kupperman score, KPS score, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol with （LDL-C）, total cholesterol （TC） and 3 acyl glycerine （TG） of the two groups were compared before and after treatment. Clinical and pathological characteristics of the two groups were recorded and compared.[Results] After treatment, Kupperman scores of the control group and the observation group were statistically significant different than those before treatment （both P 〈 0.05）. After treatment, the KPS score of the observation group was significantly higher than that before treat- ment （ P 〈0.05）. Compared with the control group, the KPS score of the study group was significantly high- er （ P 〈0.05）. After treatment, HDL-C of the control group increased significantly （ P 〈0.05）, LDL-C, TC significantly decreased （ P 〈0.05）, TG had no significant change （ P 〉0.05） ; blood lipid levels of the obser vation group were lower than those before treatment （all P 〈0.05） ; The serum levels of HDL-C, LDL C, TC, TG in the observation group were significantly lower than those in the control group （ P 〈0.05）. There was no statistical and significant difference in the incidence of complications, tumor location, axillary lymph node metastasis, chemotherapy and chemotherapy tolerance between the two groups（average P 〉0.05） ;In the comparison of endocrine drug compliance and outpatient visits rate, the difference was statistically significant （ P 〈0.05）.[Conclusion]Compared with toremifene, letrozole can significantly improve the clinical symptoms of elderly patients with breast cancer, improve the quality of life, reduce blood lipid levels with a better drug compliance and regular outpatient follow-up rate.