Treatment of breast cancer with medroxyprogesterone acetate.
Treatment of breast cancer with medroxyprogesterone acetate.
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用醋酸甲羟孕酮治疗乳腺癌。
DOI：
10.7326/0003-4819-68-2-328
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发表时间：
1968
影响因子：
39.2
通讯作者：
G. Hyman
中科院分区：
文献类型：
--
作者：
F. Muggia;P. Cassileth;M. Ochoa;F. Flatow;Alfred C. Gellhorn;G. Hyman
研究了大剂量醋酸甲羟孕酮（MPA）在治疗弥散性乳腺癌患者中的长期应用。患者包括17名曾接受过1种或1种以上激素治疗的绝经后妇女（I组），17名在研究前接受过MPA治疗的女性（卵巢切除或自然绝经后）（II组）和2名患有乳腺癌的男性（III组）。除4例患者外，所有患者均接受肌内注射（以Depo-Provera形式，100mg，每周3次，34例患者）或口服（以Provera形式，100mg，每天，2例患者），疗程至少为5周。患者被分类为显示客观肿瘤消退或治疗失败。4例患者因治疗神经系统并发症，被判定为不可评价。5例i组患者和2例ii组患者（均大于绝经10年）出现客观肿瘤消退。7例患者均经肠外注射MPA。研究结束时，客观缓解的平均持续时间为12个月。7例患者中有3例在写作时持续缓解，2例已经死亡，2例正在接受其他药物治疗。这些患者的受累部位主要是骨骼(3)、内脏(2)或软组织(2)。应答者平均年龄69岁。应答者从初始治疗到远端转移临床表现的平均“自由间隔”为44个月。第一组的5名患者均受益于先前的激素改变。10例患者在单用MPA治疗后立即接受雌激素联合MPA治疗，5例患者表现出客观的肿瘤消退，1例患者单用MPA治疗有应答。在这组患者中，反应最好的是一名61岁的男性。大多数患者服用MPA后无不良反应。对MPA的文献进行了相当广泛的讨论。
The prolonged administration of large doses of medroxyprogesterone acetate (MPA) in the treatment of patients with disseminated breast cancer was studied. The patients consisted of 17 postmenopausal women previously treated with 1 or more hormones (group I), 17 women (oophorectomized or postnatural menopause) who had received MPA prior to the study (group II), and 2 males with breast carcinoma (group III). Patients received MPA intramuscularly (as Depo-Provera, 100 mg 3 times weekly, 34 patients) or orally (as Provera, 100 mg daily, 2 patients), in all except 4 cases for a minimum of 5 weeks. Patients were classified as showing objective tumor regression or as being treatment failures. 4 patients, because of treatment for neurological complications, were judged not evaluable. 5 group-I patients and 2 group-II patients (both greater than 10 years since menopause) experienced objective tumor regression. All 7 patients received the MPA parenterally. By the end of the study mean duration of the objective remissions was 12 months. 3 of the 7 patients continued in remission at writing, 2 had succumbed to the disease, and 2 were receiving other agents. Site of involvement in these patients was predominantly osseous (3), visceral (2), or soft tissue (2). Mean age of the 7 responders was 69. The mean "free interval" from initial therapy to clinical appearance of distal metastases was 44 months in the responders. All 5 patients from group I had benefited from previous hormonal alterations. Of 10 patients receiving estrogens in combination with MPA immediately after the course of MPA alone, 5 demonstrated objective tumor regression, 1 who had responded to MPA alone. The best response in this group occurred in a 61-year old man. Most patients had no untoward effects with MPA administration. A fairly extensive discussion of the literature on MPA is included.