Tamoxifen in the treatment of breast cancer.
Tamoxifen in the treatment of breast cancer.
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DOI：
10.7326/0003-4819-109-3-219
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发表时间：
1988-08
影响因子：
39.2
通讯作者：
S. Legha
中科院分区：
文献类型：
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作者：
S. Legha
他莫昔芬，一种抗雌激素，是雌二醇的竞争性抑制剂，阻断其对目标器官的作用。在美国使用的10年里它比雌激素更适合用于治疗绝经后的转移性乳腺癌妇女。最近，他莫昔芬被用于治疗绝经前妇女复发性乳腺癌，其疗效已被证明与卵巢消融术相当。在比较试验中，他莫昔芬与其他内分泌治疗方法一样有效，而且毒性大大降低，没有不可逆的副作用。由于局部淋巴结转移的乳腺癌患者（II期）全身复发的风险很高，他莫昔芬被评价为局部治疗肿瘤后的辅助治疗。这些试验的结果显示，经他莫昔芬治疗的绝经后妇女的无病生存率显著提高，尤其是激素受体阳性肿瘤患者。他莫昔芬在绝经前妇女中还不如辅助治疗有用，对绝经前妇女来说，联合化疗是治疗的选择。
Tamoxifen, an antiestrogen, is a competitive inhibitor of estradiol, blocking its effects on the target organs. During the 10 years it has been used in the United States it has become preferred over estrogens for treating postmenopausal women with metastatic breast cancer. Recently, tamoxifen has been used in treating premenopausal women with recurrent breast cancer, and its efficacy has been proved equal to that of ovarian ablation. In comparative trials, tamoxifen has been as effective as alternative endocrine treatments, and has greatly reduced toxicity and no irreversible side effects. Because of the high risk for systemic relapse in patients with breast cancer with regional lymph node metastases, (stage II), tamoxifen has been evaluated as adjuvant therapy after local treatment of the tumor. The results of these trials have shown a significant increase in the disease-free survival of postmenopausal women treated with tamoxifen, particularly in patients with hormone-receptor-positive tumors. Tamoxifen has not been as useful as adjuvant treatment in premenopausal women, for whom combination chemotherapy is the treatment of choice.