来曲唑在绝经后受体阳性乳腺癌新辅助内分泌治疗中的应用

目的评估来曲唑在绝经后雌激素和／或孕激素受体（ER／PR）阳性乳腺癌新辅助内分泌治疗中临床应用价值、耐受性及与临床病理因素的相关性。方法38例绝经后中晚期乳腺癌，给予来曲唑治疗3～12个月，平均4个月，并观察疗效，手术前后肿瘤标本进行ER，PR，Her-2，Ki-67检测，术后继续服用来曲唑，并随访1～3年。结果临床客观缓解68．4％，超声客观缓解55．3％，3例进展（7．9％）后改为化疗。病理评价（33例手术）完全缓解1例（2．6％），部分缓解26例（78．8％），稳定6例（18．2％）。治疗后33例（86．8％）病人行手术治疗，其中保乳手术7例（21．2％），改良根治术26例（78．8％）。组织学分级低的肿瘤有效率高（P〈0．05）。疗效与HER-2表达情况无关，Ki-67在治疗后下降，治疗前后相比差异显著（氏0．05）。治疗中6例病人出现Ⅰ级不良反应（15．8％）。部分病人治疗后雌或孕激素受体表达消失。结论绝经后受体阳性乳腺癌采用来曲唑新辅助内分泌治疗安全、有效、耐受性好，治疗后保乳率高，特别对年老体弱者是一良好选择。

Application of Letrozole in Neoadjuvant Endocrine Therapy for Postmenopausal Breast Cancer with Receptor Positive

OBJECTIVE To assess clinical application value,survivability,and the correlation to clinicopathologic factors of neoadjuvant endocrine therapy for postmenopausal breast cancer patients with ER(+) and/or PR(+).METHODS A total of 38 elderly patients with breast cancer were given letrozole for 3-12 months,4 months in average,ER,PR,Her-2 and Ki-67 were detected before and after surgery,all patients were followed up for one to three years.RESULTS Clinical objective response is 68.4%.Sonography objective response...