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中华乳腺病杂志(电子版) ›› 2017, Vol. 11 ›› Issue (01) : 1 -5. doi: 10.3877/cma.j.issn.1674-0807.2017.01.001

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乳腺癌内分泌治疗是否已全面进入十年时代?
刘强1,(), 李舜颖1   
  1. 1.510120 广州,中山大学孙逸仙纪念医院乳腺外科
  • 收稿日期:2016-09-07 出版日期:2017-02-01
  • 通信作者: 刘强

Endocrine therapy of breast cancer: new era of 10-year administration?

Qiang Liu1,(), Shunying Li1   

  1. 1.Department of Breast Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120,China
  • Received:2016-09-07 Published:2017-02-01
  • Corresponding author: Qiang Liu
引用本文:

刘强, 李舜颖. 乳腺癌内分泌治疗是否已全面进入十年时代?[J/OL]. 中华乳腺病杂志(电子版), 2017, 11(01): 1-5.

Qiang Liu, Shunying Li. Endocrine therapy of breast cancer: new era of 10-year administration?[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2017, 11(01): 1-5.

ER 阳性乳腺癌患者标准的内分泌辅助治疗是采用5 年他莫昔芬或芳香化酶抑制剂治疗。 近年来,ATLAS、aTTom、MA.17R 等一系列临床研究结果显示,10 年内分泌治疗比5 年内分泌治疗更能进一步降低患者的复发率和病死率,但是,与5 年内分泌治疗相比,10 年内分泌治疗的不良反应发生率也相应提高。 BIG 1-98研究显示,患者的低依从性与缩短的DFS 相关,而不良反应是治疗中止的主要原因。 2016 版《NCCN 乳腺癌临床实践指南》已经把10 年他莫昔芬治疗纳入推荐方案之一。 但是,是否进行10 年内分泌治疗,需要结合患者的ER 状态、耐受性和依从性综合考虑。 笔者概述了乳腺癌内分泌治疗相关临床研究进展,并对10 年内分泌治疗的优势和劣势进行了阐述和总结。

For ER positive breast cancer, the standard adjuvant endocrine therapy is 5-year use of tamoxifen or aromatase inhibitors. Recently, a series of clinical trials (ATLAS,aTTom, MA. 17R) have showed that compared with 5-year endocrine therapy, 10-year endocrine therapy can reduce recurrence and mortality, but increase the rate of adverse events. The results of BIG 1-98 study suggested that low compliance is associated with shortened DFS, and adverse event is the main cause of incompliance. The 2016 NCCN clinical practice guidelines in breast cancer has already included 10-year therapy of tamoxifen as one of the recommended regimens. However, other factors like ER status, tolerance and compliance should be taken into consideration to judge whether the patient is suitable for 10-year endocrine therapy. In this paper, we reviewed the recent studies on endocrine therapy of breast cancer, and summarized the advantages and disadvantages of 10-year endocrine therapy.

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