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华西医学  2011 

老年性局部晚期乳腺癌术前内分泌治疗的临床应用

, PP. 975-978

Keywords: 老年性乳腺癌,术前治疗,内分泌治疗,芳香化酶抑制剂

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Abstract:

【】 目的 探讨老年性乳腺癌术前内分泌治疗效果及降期后手术优点。 方法 2004年5月-2010年12月19例老年性局部晚期乳腺癌患者,术前给予口服芳香化酶抑制剂(aromataseinhibitors,AI)2~10个月,进行疗效观察,降期后手术及术后同一有效内分泌药物继续治疗并随访,时间1~66个月。 结果 自AI治疗开始至手术时,临床完全缓解2例,部分缓解11例,稳定3例,进展3例;手术14例,另5例由于全身状况差、基础疾病严重不能耐受手术或局部进展而放弃手术,5年总生存率68%,无瘤生存率47%。 结论 术前内分泌治疗疗效可靠,不良反应轻,特别适应老年伴有内科疾病不适应化学疗法的患者,可以增加保乳手术率和手术切除率。【Abstract】 Objective Toinvestigatetheclinicalvalueofneo-adjuvantendocrinetherapyforlocallyadvancedbreastcancerinelderlypatientsandtheadvantagesofoperationafterdown-stagingofbreastcancer. Methods FromMay2004toDecember2010,19patientswithlocallyadvancedbreastcancerweretreatedwithAromataseinhibitor(AI)neo-adjuvantendocrinetherapyfor2to10monthsbeforeoperation.Theclinicalefficacywasobserved.Operationwasperformedafterdown-stagingofthecancer.Aftertheoperation,patientscontinuedtakingthesameeffectivedrugandwerefollowed-upfor1to66months. Results FromAItreatmenttothetimeofoperation,therewere2casesofclinicalcompleteresponse,11casesofclinicalpartialresponse,3casesofstabledisease,and3casesofprogressivedisease.Atotalof14patientswereoperated,and5otherpatientscouldnothavetheoperationforbadbodyconditions,seriousbasic-diseasesorlocalprogressofthedisease.The5-yearoverallsurvivalratewas68%,andthedisease-freesurvivalratewas47%. Conclusion Neo-adjuvantendocrinetherapyhasareliableclinicaleffectandlowside-effects.Itisespeciallysuitableforelderlypatientsexcludedfromchemotherapybecauseofinternalmedicaldiseases.Itcanalsoincreasetherateofbreast-conservingandsurgicalexcision.

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