效干预措施使其不发生,因此而挽回的经济损失是.PDFVIP

来曲唑在绝经后受体阳性乳腺癌新辅助内分泌治疗中的应用 李艳萍，高宏，冯宇，吕淑贞(北京世纪坛医院肿瘤外科乳腺中心，北京 100038) 摘要：目的 评估来曲唑在绝经后雌激素和/或孕激素受体(ER/PR) 阳性乳腺癌新辅助内分泌治疗中临床应用价值、耐受性及 与临床病理因素的相关性。方法 38 例绝经后中晚期乳腺癌，给予来曲唑治疗 3~12 个月，平均 4 个月，并观察疗效，手术 前后肿瘤标本进行 ER ，PR ，Her-2 ，Ki-67 检测，术后继续服用来曲唑，并随访 1~3 年。结果 临床客观缓解 68.4% ，超声 客观缓解 55.3% ，3 例进展(7.9%)后改为化疗。病理评价(33 例手术)完全缓解 1 例(2.6%) ，部分缓解 26 例(78.8%) ，稳定 6 例(18.2%)。治疗后 33 例(86.8%)病人行手术治疗，其中保乳手术 7 例(21.2%) ，改良根治术 26 例(78.8%)。组织学分级低的 肿瘤有效率高(P0.05) 。疗效与 HER-2 表达情况无关，Ki-67 在治疗后下降，治疗前后相比差异显著(P0.05) 。治疗中 6 例 病人出现Ⅰ级不良反应(15.8%)。部分病人治疗后雌或孕激素受体表达消失。结论 绝经后受体阳性乳腺癌采用来曲唑新辅 助内分泌治疗安全、有效、耐受性好，治疗后保乳率高，特别对年老体弱者是一良好选择。 关键词：来曲唑；绝经后乳腺癌；新辅助内分泌治疗；受体阳性 中图分类号：R979.1 文献标志码：B 文章编号：1007-7693(2010)04-0365-05 作者简介：李艳萍，女，博士，副教授，硕导 Tel:E-mail: liyanping112@ 中国现代应用药学2010 年 4 月第 27 卷第 4 期 Chin JMAP, 2010 April, Vol.27 No.4 ·365 · Application of Letrozole in Neoadjuvant Endocrine Therapy for Postmenopausal Breast Cancer with Receptor Positive LI Yanping, GAO Hong, FENG Yu, LÜ Shuzhen(Department of Breast, Beijing Shijitan Hospital, Beijing 100038, China) ABSTRACT: OBJECTIVE To assess clinical application value, survivability, and the correlation to clinicopathologic factors of neoadjuvant endocrine therapy for postmenopausal breast cancer patients with ER(+) and/or PR(+). METHODS A total of 38 elderly patients with breast cancer were given letrozole for 312 months, 4 months in average，ER ，PR ，Her-2 and Ki-67 were detected before and after surgery, all patients were followed up for one to three years. RESULTS Clinical objective response is 68.4%. Sonography objective response is 55.3%. Complete remission achieved in 1 case (2.6%), partial remission in 26 cases(78.8%), no change in 6 cases(18.2%), the disease in 3 cases(7.9%) was progressed and changed into chemotherapy later. 33 cases(86.8%) were performed operation after treatment, 7 cases(21.2%)