卵巢功能抑制联合芳香化酶抑制剂或他莫昔芬治疗绝经前HR阳性乳腺癌的研究进展

Ovarian function suppression plus aromatase inhibitor or tamoxifen in the treatment of premenopausal HR-positive breast cancer

关键词:  HR阳性乳腺癌  绝经前  辅助内分泌治疗  他莫昔芬  芳香化酶抑制剂  卵巢功能抑制

Key words:  HR-positive breast cancer  premenopausal  adjuvant endocrine therapy  TAM  AI  OFS

摘要:

绝经前激素受体（hormone receptor，HR）阳性乳腺癌的辅助内分泌治疗是近年的热点问题。绝经前HR阳性乳腺癌的内分泌治疗包括选择性雌激素受体调节剂（selective estrogen receptor modulator，SERM），例如他莫昔芬（tamoxifen，TAM）；卵巢功能抑制（ovarian function suppression，OFS），包括手术、放疗或药物去势；OFS联合TAM；以及芳香化酶抑制剂（aromatase inhibitors，AI）联合OFS。目前建议对复发风险较高的绝经前HR阳性乳腺癌患者使用（AI或TAM）+OFS，但TAM+OFS与AI+OFS之间疗效是否存在差异仍待进一步探索。本文就目前绝经前HR阳性乳腺癌患者的TAM+OFS与AI+OFS之间的疗效及不良反应差异进行综述。

Abstract:

Adjuvant endocrine therapy for premenopausal hormone receptor (HR) positive breast cancer has been a hot topic in recent years. Endocrine therapy for premenopausal HR-positive breast cancer includes selective estrogen receptor modulators (SERM) such as tamoxifen (TAM), ovarian function suppression (OFS) including surgery, radiation or drug castration, TAM combined with OFS, and aromatase inhibitor (AI) combined with OFS. AI or TAM plus OFS is currently recommended for premenopausal HR-positive breast cancer patients with a higher risk of recurrence. However, there is still more to be explored on whether there is a difference between TAM plus OFS and AI plus OFS. This review focuses on the differences in efficacy and side effects between TAM plus OFS and AI plus OFS in the treatment of premenopausal HR-positive breast cancer patients.