摘要
背景与目的:目前绝经前晚期乳腺癌的疗效仍不甚理想,卵巢去势是激素受体阳性晚期乳腺癌的有效治疗手段之一,卵巢去势药物促黄体激素释放激素类似物(luteinizing hormone-releasing hormone,LHRH),如戈舍瑞林,与手术或放疗去势疗效相当。本研究旨在探讨戈舍瑞林联合内分泌药物治疗激素受体阳性的绝经前晚期乳腺癌的疗效。方法:戈舍瑞林联合内分泌药物治疗组30例,个体匹配,选取同期30例应用三苯氧胺治疗的患者作为对照组,采用Kaplan-Meier法计算生存率,用log-rank方式进行差异的显著性检验,主要研究指标为无疾病再次进展生存时间(progression-free survival,PFS)和总生存时间(overall survival,OS)。结果:治疗组和对照组的中位PFS分别为47.9个月和16.7个月,1、2和3年无疾病再次进展生存率分别为86.7%vs 58.9%,73.0%vs 43.1%和62.6%vs 38.3%(P=0.039);治疗组和对照组1、2和3年的总生存率分别为100%vs 83.3%、82.9%vs 57.5%和79.1%vs 48.9%(P=0.010)。年龄<40岁的患者,治疗组的PFS(P=0.027)和OS(P=0.007)较对照组显著提高,年龄≥40岁的患者使用戈舍瑞林则对预后无影响(P>0.05)。疾病再次进展后继续使用戈舍瑞林中位生存时间较未使用者显著延长(28.2个月vs 7.0个月),具有潜在受益(P=0.070)。结论:对于激素受体阳性的绝经前晚期乳腺癌,戈舍瑞林联合内分泌药物可作为年龄<40岁患者的标准内分泌治疗方法,对于出现疾病再次进展的患者,建议继续使用戈舍瑞林。
Background and purpose： The not satisfactory. Ovarian suppression is an effective （LHRH） agonists, like goserelin, have been shown to treatment for premenopausal advanced breast cancer is still treatment because luteinising hormone releasing hormone produce the same effective ovarian function suppression as surgical oophorectomy or ovarian irradiation does. The purpose of this study was to explore the effects of goserelin in combination with endocrine therapy for advanced breast cancer in premenopausal women with positive hormone receptors. Methods： Thirty cases were selected to undergo goserelin in combination with endocrine treatment while another 30 cases that were not treated with goserelin served as the control group. The Kaplan-Meier survival method and log-rank method were used to test for significant differences. Results： For both the treatment and control group, the median time to progression were 47.9 months and 16.7 months, respectively. The 1, 2 and 3-year progression-free survival rate （PFS） were 86.7% vs 58.9%, 73.0 % vs 43.1% and 62.6% vs 38.3%, respectively （P=0.039）. The 1, 2 and 3-year overall survival rate （OS） were 100% vs 83.3%, 82.9% vs 57.5%, 79.1% vs 48.9% （P=0.010） for the treatment group and control group, respectively. For those in the treatment group with an age of〈40 years, PFS （P=0.027） and OS （P=0.007） were significantly longer than ones in the control group but there was no effect on the prognosis for patients ≥ 40 years. There is a potential OS benefit for those who continued to use goserelin after the disease has progressed again because the median survival time for them was significantly longer that in non users （28.2 months vs 7.0 months） （P=0.070）. Conclusion： For premenopausal hormone receptor positive advanced breast cancer patients, goserelin when combined with endocrine therapy can be used as the standards for endocrine treatment for patients 〈40 years. This study recommended the continued usage of goserelin for patients wi
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2011年第8期626-631,共6页
China Oncology
