LONG-TERM ADJUVANT TAMOXIFEN IN EARLY BREAST-CANCER - EFFECT ON BONE-MINERAL DENSITY IN POSTMENOPAUSAL WOMEN
LONG-TERM ADJUVANT TAMOXIFEN IN EARLY BREAST-CANCER - EFFECT ON BONE-MINERAL DENSITY IN POSTMENOPAUSAL WOMEN
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DOI：
10.1200/jco.1990.8.6.1019
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发表时间：
1990-06-01
影响因子：
45.3
通讯作者：
GLAS, U
中科院分区：
文献类型：
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作者：
FORNANDER, T;RUTQVIST, LE;GLAS, U
绝经后性类固醇激素水平的下降与骨质流失和随后的骨质疏松症有关。他莫昔芬具有抗雌激素特性，因此理论上可能会降低骨密度，特别是在长期治疗后。对75例无复发的绝经后乳腺癌患者进行了骨密度（BMD）评估，这些患者参加了一项辅助性他莫昔芬（每日40 mg）治疗2年或5年与无辅助性内分泌治疗的随机试验。在初始随机化后约7年进行测量。采用单光子吸收法（SPA）测量前臂远端两个水平（代表皮质骨和松质骨）的BMD。三苯氧胺组的BMD与对照组相似。对于皮质骨，他莫昔芬患者的BMD为1.03 g/cm 2（95%置信区间[CI]，0.97至1.09），对照组为1.03 g/cm 2（95% CI，0.96至1.11）。对于骨小梁，数值分别为0.74 g/cm 2（95% CI，0.70 - 0.79）和0.73 g/cm 2（95% CI，0.68 - 0.79）。因此，结果并不表明长期辅助他莫昔芬会加速绝经后骨质流失。
The decrease in sex steroid hormone levels after the onset of menopause is associated with bone loss and subsequent osteoporosis. Tamoxifen has antiestrogenic properties and may thus theoretically decrease bone mineral density, particularly after long-term treatment. Bone mineral density (BMD) was assessed in 75 recurrence-free postmenopausal breast cancer patients included in a randomized trial of adjuvant tamoxifen (40 mg daily) for 2 or 5 years versus no adjuvant endocrine therapy. The measurements were done about 7 years after the initial randomization. BMD was measured with single-photon absorptiometry (SPA) at two levels of the distal forearm representing cortical and trabecular bone. The BMD was found to be similar among tamoxifen patients compared with the controls. For cortical bone, the BMD was 1.03 g/cm2 (95% confidence interval [Cl], 0.97 to 1.09) among tamoxifen patients and 1.03 g/cm2 (95% Cl, 0.96 to 1.11) in controls. For trabecular bone, the values were 0.74 g/cm2 (95% Cl, 0.70 to 0.79) and 0.73 g/cm2 (95% Cl, 0.68 to 0.79), respectively. The resultsthus did not indicate an accelerated postmenopausal bone loss with long-term adjuvant tamoxifen.