2001-2010 年我院采用内分泌疗法治疗老年乳腺癌的临床效果分析

目的：分析内分泌治疗在老年患者乳腺癌中的疗效。方法：回顾性分析2001 年1 月至2010 年12 月我院外科手术切除的≥ 60 岁的116 例乳腺癌患者的临床资料，按照内分泌治疗分成三组，不进行内分泌治疗的对照组、三苯氧胺（TAM）组和芳香化酶抑 制剂（AI）组，比较不良反应、存活时间及存活率。结果：对照组的副作用发生率为75.86%，副作用主要为关节痛、其他关节症状和 子宫内膜增厚；TAM 组的副作用发生率为63.33%，副作用主要为其他关节症状和子宫内膜增厚；AI 组的副作用发生率为 55.56%，副作用主要为其他关节症状和子宫内膜增厚。三组患者的不良反应如潮红、妇科症状、子宫切除和静脉栓塞等发生率低, 总不良反应发生率无显著性差异（P=0.802）。对照组的中位生存时间为7.35 年，TAM组的中位生存时间为10.46 年，AI组的中位 生存时间为9.94 年，三组患者的生存时间具有显著性差异（P=0.001），TAM组和AI组的生存时间显著高于对照组。对照组、ATM 组、AI 组的5 年生存率为74%、90%、71%,10 年生存率为24%、71%、68%，三组患者的生存率具有显著性差异（P=0.007），TAM组 和AI组的生存率均显著高于对照组。结论：性激素受体阳性老年乳腺癌患者总体预后较好。TAM、AI用于性激素受体阳性的老 年乳腺癌患者的治疗，具有较好的疗效与安全性。

Clinical Effects of Endocrinotherapy on the Treatment of Breast Cancer for Elderly Patients from2001 to 2010

Objective:To analyze the therapeutic effect of endocrinotherapy on the treatment of breast cancer for elderly patients.Methods:116 cases with breast cancer who were more than 60 years old and received surgical treatment from January 2001 to December 2010 in our hospital were selected and randomly divided into three groups: the control group, in which the patients didn''t accept endocrinotherapy, the TAM group and the AI group on the basis of endocrinotherapy. Then the adverse reactions, the rate and time of survival were compared and analyzed.Results:The rate of adverse reactions in the untreated group was 75.86%, which mainly including the arthralgia, symptoms of other joints, and endometrial thickening; The rate of adverse reactions in the TAMgroup was 63.33%, which mainly including the symptoms of other joints and endometrial thickening; The rate of adverse reactions in the AI group was 55.56%, which mainly including the symptoms of other joints and endometrial thickening. The adverse effect rates of flushing, gynecological symptoms, hysterectomy and venous embolism were lower in three groups with no statistically significant differences (P=0.802). The intermediate time of survival was 7.35 years in the untreated group, 10.46 years in TAM group and 9.94 years in AI group with statistically significant differences among three groups (P=0.001). The rate of five-year''s survival in the untreated group, the TAMgroup and AI group were 74%, 90% and 71%, respectively. The rate of ten-year''s survival in untreated, TAM and AI groups were 24%, 71% and 68%, respectively, there was significant differences(P=0.007). The survival rate in TAMand AI groups were significantly higher than that of the untreated group.Conclusion:The prognosis of estrogen receptor positive elderly breast cancer patients was comparatively good. Applying TAMor AI on estrogen receptor positive elderly breast cancer patient showed satisfying therapeutic effect and safety.