依西美坦与三苯氧胺对绝经后晚期乳腺癌新辅助内分泌治疗临床疗效分析

Clinical Analysis of Exemestane and Tamoxifen as Neoadjuvant Endocrine Therapy for Postmenopausal Advanced Breast Cancer

目的探讨依西美坦与三苯氧胺对绝经后晚期乳腺癌患者新辅助内分泌治疗的临床治疗效果。方法40例绝经后晚期乳腺癌患者依据随机数字表法分为观察组与对照组各20例。观察组口服依西美坦,对照组服用三苯氧胺,观察2组临床疗效、雌二醇(E_(2))抑制率及不良反应。结果观察组治疗后CR 2例、PR 4例、SD 10例、PD 4例,总缓解率30%,临床受益率80%;对照组治疗后CR 1例、PR 3例、SD 9例、PD 7例,总缓解率20%,临床受益率为65%;总缓解率、临床受益率组间比较差异有统计学意义(P<0.05)。观察组患者治疗前E_(2)水平为28.76pmol·L^(-1),治疗后为17.70pmol·L^(-1),E_(2)抑制率为38.46%;对照组患者治疗前E_(2)水平为27.33pmol·L^(-1),治疗后为19.31pmol·L^(-1),E_(2)抑制率为29.35%,组间E_(2)抑制率比较差异有统计学意义(P<0.05)。2组患者治疗过程中均无因药物不良反应停止治疗病例,不良反应均为轻症,观察组不良反应发生率低于对照组(P<0.05)。结论在绝经后晚期乳腺癌新辅助内分泌治疗中依西美坦疗效优于三苯氧胺,不良反应发生率低于三苯氧胺,可根据患者实际病情优先选用。

Objective To investigate the clinical effect of exemestane and tamoxifen on neoadjuvant endocrine therapy in postmenopausal patients with advanced breast cancer.Methods A total of 40 postmenopausal patients with advanced breast cancer were randomly divided into an observation group and a control group with 20 cases in each group.The observation group took exemestane orally and the control group took tamoxifen.The clinical efficacy,estradiol(E_(2))inhibition rate and adverse reactions of the two groups were observed.Results In the observation group,there werE_(2) cases of CR,4 cases of PR,10 cases of SD and 4 cases of PD after treatment,with a total remission rate of 30%and a clinical benefit rate of 80%.In the control group,there were 1 case of CR,3 cases of PR,9 cases of SD and 7 cases of PD.The total remission rate was 20%and the clinical benefit rate was 65%,the total remission rate and clinical benefit rate were statistically significant(P<0.05).The level of E_(2) in the observation group was 28.76 pmol·L^(-1)before treatment and 17.70 pmol·L^(-1)after treatment,and the inhibition rate of E_(2) was 38.46%;The level of E_(2) in the control group was 27.33 pmol·L^(-1)before treatment and 19.31 pmol·L^(-1)after treatment,and the inhibition rate of E_(2) was 29.35%.There was a significant difference between the two groups(P<0.05).During the treatment,there was no case of stopping treatment due to adverse drug reactions in both groups,and the adverse reactions were mild.The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion Exemestane is more effective than tamoxifen in neoadjuvant endocrine therapy for postmenopausal advanced breast cancer,and the incidence of adverse reactions is lower than tamoxifen.It can be selected preferentially according to the actual condition of patients.