他莫昔芬与来曲唑在绝经后乳腺癌辅助内分泌治疗中临床对比研究

摘要

Objective:To explore the efficacy of tamoxifen and letrozole in the adjuvant hormonal therapy of postmeno-pausal breast cancer.Methods:A total of 60 patients with postmenopausal breast cancer who were admitted in our hospital from May,2012 to May,201 5 were included in the study and randomized into the observation group and the control group. The patients in the observation group were given letrozole,while the patients in the control group were given tamoxifen.The change of serum VEGF level before and after treatment,the mass shrinking degree after treatment,and the change of tumor grading in the two groups were observed.The clinical efficacy and adverse reactions were compared.Results:After treatment, the serum VEGF level in the observation group [(145.79 ± 41.28)pg/mL]was significantly lower than that in the control group [(214.62±53.5 1)pg/mL](P <0.05).The mass shrinking degree in the observation group (56.89±1 5.43)was signifi-cantly greater than that in the control group (45.1 7±1 1.1 6).In the tumor grading,46.67% (14/30)at stage I in the observa-tion group was significantly greater than that in the control group [13.33% (4/30)],13.33% (4/30)at stage III significantly less than that in the control group [36.67% (1 1/30)](P <0.05).The total response rate in the observation group [90.00%(27/30)]was significantly higher than that in the control group [66.66% (20/30)](P <0.05).Conclusions:In the neoadju-vant endocrine therapy of postmenopausal breast cancer,letrozole has a better effect than tamoxifen,and can significantly re-duce the tumor grading;therefore,it deserves to be widely recommended in the clinic.%目的：：探讨他莫昔芬与来曲唑在绝经后乳腺癌辅助内分泌治疗中的对比情况.方法：选择2012年5月~2015年5月接诊的60例绝经后乳腺癌患者,按照随机数表法分为观察组和对照组,观察组给予来曲唑治疗,对照组给予他莫昔芬治疗,观察两组患者治疗前后血清 VEGF 水平变化情况、治疗后肿块缩小程度以及肿瘤分级变化,比较临床疗效以及不良反应发生情况.结果：治疗后,观察组血清VEGF 水平(145．79±41．28)pg/mL 低于对照组(214．62±53．51)pg/mL,差异具有统计学意义(P ＜0．05)；观察组肿块缩小程度为(56．89±15．43)大于对照组的(45．17±11．16),肿瘤分级中,观察组在Ⅰ期人数为46．67％(14/30)多于对照组的13．33％(4/30),Ⅲ期人数为13．33％(4/30)少于对照组的36．67％(11/30),差异均具有统计学意义(均 P ＜0．05)；观察组总缓解率90．00％(27/30)高于对照组66．66％(20/30),差异具有统计学意义(P ＜0．05).结论：在对绝经后乳腺癌患者的新辅助内分泌治疗中,来曲唑比他莫昔芬效果更为优异,在降低患者的肿瘤分期上疗效显著,值得在临床上应用推广.