Clinical observation of tamoxifen in hormone receptor - positive postmenopausal patients with metastatic breast cancer failing to Aromatase inhibitors

目的：探讨他莫昔芬治疗芳香化酶抑制剂（AIs）耐药的激素受体阳性（HR ＋）绝经后转移性乳腺癌（MBC）患者的疗效和安全性。方法：回顾性分析他莫昔芬治疗 AIs 耐药的30例 HR ＋绝经后 MBC 患者的临床资料，观察终点为缓解率（RR）、临床获益率（CBR）、疾病进展时间（TTP）和安全性。结果：30例患者中，CR 1例，PR 9例，SD 15例，RR 为33.3％，CBR 为50％，中位 TTP 6.1个月。23例骨和/或软组织转移患者中，RR为34.8％，CBR 为52.2％，中位 TTP 7.3 个月；7例肝脏和/或肺部转移患者中，RR 为28.6％，CBR 为42.8％，中位 TTP 4.8 个月（P =0.019）。不良反应多为面部潮红、阴道干燥、白带增多、阴道出血、恶心、呕吐、腹泻等，均为 I、II 级。结论：他莫昔芬治疗 AIs 耐药的 HR ＋绝经后 MBC 患者安全有效，可改善患者预后。Objective:To investigate the curative effect and safety of tamoxifen in hormone receptor - positive (HR + )postmenopausal patients with metastatic breast cancer(MBC)failing to Aromatase inhibitors(AIs). Meth-ods:Retrospectively analyzed clinical data of 30 patients with HR + postmenopausal MBC treated with tamoxifen after AIs resistance. The endpoints were response rate(RR),clinical benefit rate(CBR),time of tumor progression(TTP) and safety. Results:In 30 patients,the patients who acquired CR,PR and SD were 1,9 and 15. The RR and CBR were 33. 3% and 50% . The median TTP was 6. 1 months. The RR and CBR in 23 cases with bone and/ or soft tissue me-tastasis and 7 cases of liver and/ or pulmonary metastasis were 34. 8% ,52. 2% and 28. 6% ,42. 8% . The median TTP were 7. 3 and 4. 8 months in two groups(P = 0. 019). The most common adverse reactions were hot flashes,vaginal dryness,vaginal discharge,vaginal bleeding,nausea,vomiting,diarrhea and so on. Most side effects were grade Ⅰ orⅡ on the WHO scale. Conclusion:Treatment with tamoxifen in AIs resistant HR + postmenopausal patients with MBC is safe and effective,can improve prognosis of patients.深圳市卫生计生系统科研项目中国科技核心期刊(ISTIC)07966-96