Crossover trial for lipid abnormality in postmenopausal breast cancer patients during selective estrogen receptor modulators (SERMs) administrations
Crossover trial for lipid abnormality in postmenopausal breast cancer patients during selective estrogen receptor modulators (SERMs) administrations
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DOI：
10.1007/s10549-004-5449-8
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发表时间：
2004-11-01
影响因子：
3.8
通讯作者：
Aoki, T
中科院分区：
文献类型：
--
作者：
Kusama, M;Kaise, H;Aoki, T
本研究的目的是评估不同的配置文件的血脂所造成的管理选择性雌激素受体调节剂（SERM）。对1997年4月~ 2001年3月在我科或其他相关医疗机构治疗的淋巴结阴性、激素受体阳性的绝经后原发性乳腺癌患者（n = 197）进行辅助治疗。辅助治疗包括他莫昔芬（TAM）20 mg或托瑞米芬（TOR）40 mg治疗1年。观察血清总胆固醇（TC）、高密度脂蛋白胆固醇（HDL）和三酰甘油（TG）等血脂变化。给药1年后，TAM组和TOR组的TC均显著降低（p < 0.001），但两组之间无显著差异（p = 0.249）。TAM组HDL显著降低（p < 0.001），TOR组HDL显著升高（p < 0.001），组间差异有显著性（p < 0.001）。TG在TAM组中显著升高（p < 0.001），但在TOR组中显著降低（p < 0.001）。对于那些仍然有脂质代谢异常的人，药物被转换，并给予他们另一年。交叉1年后，TC和HDL升高至给药前水平（p < 0.001），TG在药物从TAM转换为TOR的患者（n 57）中降低。23例由TOR改为TAM后TC下降，TG升高（P < 0.001）。上述结果表明，TOR提供了比TAM更好的脂质代谢谱。
The objective of this study was to evaluate the different profiles of serum lipids resulting from the administration of selective estrogen receptor modulators ( SERMs). Postmenopausal primary breast cancer patients ( n = 197) with node-negative, hormone receptor-positive who were treated at our department or in other related medical institutions from April 1997 through March 2001 were given adjuvant therapy. The adjuvant therapy included 1 year's administration of tamoxifen ( TAM) 20 mg or toremifene ( TOR) 40 mg. The profiles of serum lipids such as total cholesterol ( TC), high-density lipoprotein cholesterol ( HDL) and triglyceride ( TG) were observed. After 1 year administration TC had significantly decreased ( p < 0.001) both in the TAM group and the TOR group, but no significant difference was found between these groups ( p = 0.249). HDL had significantly decreased in the TAM group ( p < 0.001), while it had significantly increased in the TOR group ( p < 0.001), and a significant difference was found between the groups ( p < 0.001). TG had significantly increased in the TAM group ( p < 0.001) but significantly decreased in the TOR group ( p < 0.001). The medication was switched in those who still had abnormal lipid metabolism and given to them for another year. After 1 year from the crossover TC and HDL had increased to the levels of before administration ( p < 0.001) and TG had decreased in those ( n 57) whose medication was switched from TAM to TOR. While TC had decreased and TG had increased in those ( n 23) whose medication was switched from TOR to TAM ( p < 0.001). The above findings have suggested that TOR provides better profiles of lipid metabolism than TAM.