Lung Cancer Mortality Risk Among Breast Cancer Patients Treated With Anti-Estrogens
Lung Cancer Mortality Risk Among Breast Cancer Patients Treated With Anti-Estrogens
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DOI：
10.1002/cncr.25638
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发表时间：
2011-03-15
期刊：
影响因子：
6.2
通讯作者：
Rapiti, Elisabetta
中科院分区：
文献类型：
--
作者：
Bouchardy, Christine;Benhamou, Simone;Rapiti, Elisabetta
背景：妇女健康倡议随机临床试验报告更年期激素治疗增加肺癌死亡风险。如果这是真的，使用抗雌激素应该与降低肺癌死亡风险有关。作者比较了接受和未接受抗雌激素治疗的乳腺癌患者的肺癌发病率和死亡率。方法：我们的研究纳入了1980年至2003年间在日内瓦癌症登记处登记的6655名诊断为乳腺癌的妇女。在这些妇女中，46%（3066）接受了抗雌激素治疗。随访所有妇女肺癌的发生和死亡情况，直至2007年12月。作者通过标准化发病率比（SIRs）和标准化死亡率比（SMRs）比较了使用和不使用抗雌激素患者与普通人群的发病率和死亡率。结果：在总共57,257人年之后，40名女性发展为肺癌。肺癌的SIRs在有抗雌激素和没有抗雌激素的乳腺癌患者中没有显著降低（分别为0.63,95%可信区间[Cl]， 0.33-1.10; 1.12, 95%可信区间[Cl]， 0.74-1.62），而在有抗雌激素的女性中SMR降低（0.13,95% Cl, 0.02-0.47, P < .001），但在没有抗雌激素的女性中没有降低（0.76,95% CI, 0.43-1.23）。结论：与一般人群的预期结果相比，接受抗雌激素治疗的乳腺癌患者肺癌死亡率较低。本研究进一步支持了雌激素治疗改变肺癌预后的假设。癌症2011;117:1288 - 95。(C) 2011年美国癌症协会
BACKGROUND: The Women's Health Initiative randomized clinical trial reported that menopausal hormone therapy increases lung cancer mortality risk. If this is true, use of anti-estrogens should be associated with decreased lung cancer mortality risk. The authors compared lung cancer incidence and mortality among breast cancer patients with and without anti-estrogen therapy. METHODS: Our study included all 6655 women diagnosed with breast cancer between 1980 and 2003 and registered at the Geneva Cancer Registry. Among these women, 46% (3066) received anti-estrogens. All women were followed for occurrence and death from lung cancer until December 2007. The authors compared incidence and mortality rates among patients with and without anti-estrogens with those expected in the general population by Standardized Incidence Ratios (SIRs) and Standardized Mortality Ratios (SMRs). RESULTS: After a total of 57,257 person-years, 40 women developed lung cancer. SIRs for lung cancer were not significantly decreased among breast cancer patients with and without anti-estrogens (0.63, 95% confidence intervals [Cl], 0.33-1.10; and 1.12, 95% Cl, 0.74-1.62, respectively) while SMR was decreased among women with anti-estrogens (0.13, 95% Cl, 0.02-0.47, P < .001) but not for women without anti-estrogens (0.76, 95% CI, 0.43-1.23). CONCLUSIONS: Compared with expected outcomes in the general population, breast cancer patients receiving antiestrogen treatment for breast cancer had lower lung cancer mortality. This study further supports the hypothesis that estrogen therapy modifies lung cancer prognosis. Cancer 2011;117:1288-95. (C) 2011 American Cancer Society