大剂量甲地孕酮和已酸孕酮治疗晚期乳腺癌

作者以大剂量甲地孕酮(High dose-Megestrol acetate HD—MA)500～1000 mg/日,或已酸羟孕酮(Hydroxyprogesterone capronte HD—HPC)500mg/日治疗17例晚期乳腺癌患者。结果HD—MA组8例中4例获PR,其中2例仍在缓解中,缓解期为45～362天(平均184天)。HD—HPC组9例中5例PR,缓解期为105～519天(平均282天)。软组织和内脏病变的疗效似胜于骨转移。经先期三苯氧胺(Tamoxifen)治疗失败的14例中,7例仍可因HD—MA或HD—HPC而缓解。除1例外,PR者均属绝经期后病人。HD—MA和HD—HPC可显著改善生活质量;多数患者疼痛明显减轻或消失,食欲改善,体重增加,KPS提高25％(MA组)或41％( HPC组)。未见其他明显的毒副反应。作者认为,HD—MA和HD—HPC作为第二线内分泌治疗手段,对于晚期、复发或难治性乳腺癌是安全、有效並有其独具的优点的。

TREATMENT OF ADVANCED BREAST CANCER PATIENTS WITH HIGH DOSE MEGESTROL ACETATE AND HYDROXYPRO-GESTERONE CAPROAT E

High dose (HD) megestrol acetate (MA, 500- 1000mg / d) and hydrox-ypogestrone caproate (HPC, 500 mg/d) were administrated on daily basis to seventeen patients with advanced breast cancer. Four of 8 patients on HD-MA achieved PR with 2 cases still on remission, progression-free interval (PFI) being 45-362 days (mean 184 d). Of 9 patients on HD-HPC, 5 were PR with PFI 105-519 days (mean 282 d ). Soft tissue and viscera predominant disease seemed to respond better than osseous metastasis. Seven of 14 cases failing to prior Tamoxifen therapy responded to HD-MA and HPC. All PR responders were postmanopausal. Pain relief, weight gain and appetite increased were impressive among the most victims. The quality of life of patients was improved showing as the increment of KPS, 25% on HD-MA, 41% on HD-HPC respectively. Side-effects were mild . In conclusion, HD-MA and HD-HPC have established a role as,second-line endocrine therapy or salvage measurement for the postmen opausal women with advanced, relapsed and refractory breast cancer.