内分泌治疗对合并甲状腺功能减退晚期乳腺癌的疗效及安全性

Effectiveness and safety of endocrine therapy for advanced breast cancer patients with hypothyroidism

目的探讨晚期激素受体阳性并发甲状腺功能减退乳腺癌患者接受内分泌治疗的疗效及安全性。方法选取徐州医科大学附属医院收治的44例激素受体(hormone receptor,HR)阳性的乳腺癌患者,根据甲状腺功能将患者分为甲状腺功能正常组(29例)、甲状腺功能减退组(15例),分别统计患者的无进展生存期(progression free survival,PFS)、甲状腺功能(FT3、FT4、TSH)、乳腺癌标志物(CEA、CA125、CA15-3)及不良反应发生的情况,进行回顾性分析。结果甲状腺功能减退组的客观有效率(ORR)与甲状腺功能正常组比较,差异无统计学差异(P>0.05);甲状腺功能减退组的中位PFS(7.5个月)略高于甲状腺功能正常组的中位PFS(6.1个月),但差异无统计学意义(P>0.05);2组患者白细胞、血小板、白蛋白减少,肝功能异常发生率比较,差异无统计学意义(P>0.05);经过2个周期治疗后,2组甲状腺功能与治疗前比较差异无统计学意义(P>0.05);2组治疗后CEA、CA125、CA15-3水平和治疗前比较,差异无统计学意义(P>0.05)。结论内分泌治疗对合并甲状腺功能减退的晚期乳腺癌患者的疗效与合并甲状腺功能正常者相近,不良反应发生率大致相同,耐受性良好。

Objective To investigate the effectiveness and safety of endocrine therapy in advanced hormone-receptor-positive breast cancer patients with hypothyroidism.Methods A total of 44 patients with hormone receptor positive breast cancer who were admitted to the Affiliated Hospital of Xuzhou Medical University were enrolled.According to their thyroid function,they were divided into two groups:a normal thyroid function group(n=29)and a hypothyroidism group(n=15).The progression free survival(PFS),thyroid function(FT3,FT4 and TSH),breast cancer markers(CEA,CA125 and CA15-3)and adverse reactions were retrospectively analyzed.Results There was no statistical difference in ORR between the normal thyroid function group and the hypothyroidism group(P>0.05).The median PFS of the hypothyroidism group(7.5 months)was slightly higher than that of the normal thyroid function group(6.1 months),without statistical difference(P>0.05).There was no statistical significance in the incidence of leukopenia,thrombocytopenia,albumin and abnormal liver function between the two groups(P>0.05).After two cycles of treatment,there was no statistical difference in thyroid function compared with those before treatment(P>0.05).There was no statistical difference in CEA,CA125 and CA15-3 between the two groups before and before treatment(P>0.05).Conclusions The use of endocrine therapy for advanced breast cancer patients with hypothyroidism exerts similar effect with those normal thyroid function,with almost the same incidence of adverse reactions and good tolerance.