BACKGROUND:Oestrogens usually stimulate the progression of oestrogen receptor (ER)-positive breast cancer. Paradoxically, high-dose oestrogens suppress the growth of these tumours in certain circumstances. METHODS:We prospectively examined the efficacy and safety of ethinylestradiol treatment (3 mg per day oral) in postmenopausal patients with advanced or recurrent ER-positive breast cancer who had previously received endocrine therapies, especially those with resistance to aromatase inhibitors. RESULTS:Eighteen patients were enrolled with the median age of 63 years and the mean observation time of 9.2 months. Three cases withdrew within 1 week due to oestrogen flare reactions with nausea, fatigue and muscle-skeletal pain. The response rate was 50% (9 out of 18), and the clinical benefit rate was 56% (10 out of 18). The stable disease (<6 months) was 17% (3 out of 18) and another 2 cases were judged as progressive disease. Time-to-treatment failure including 2 on treatment was a median of 5.6 months (range 0.1 to 14.5(+)). Although vaginal bleeding or endometrial thickening was observed in patients receiving long-term treatment, there were no severe adverse events, such as deep venous thrombosis or other malignancies. CONCLUSION:Although the mechanism of this treatment has not been fully understood, our data may contribute to change the common view of late-stage endocrine therapy.

译文

背景:雌激素通常刺激雌激素受体(ER)阳性乳腺癌的进展。矛盾的是,大剂量雌激素在某些情况下会抑制这些肿瘤的生长。
方法:我们前瞻性地研究了乙炔雌二醇治疗(每天口服3 mg)在绝经后患有晚期或复发性ER阳性乳腺癌的绝经后患者中的有效性和安全性,这些患者先前曾接受过内分泌治疗,尤其是那些对芳香酶抑制剂具有抗药性的患者。
结果:18例患者的中位年龄为63岁,平均观察时间为9.2个月。 1星期内有3例患者因雌激素反响,恶心,疲劳和肌肉骨骼疼痛而退出治疗。缓解率为50%(18个中的9个),临床受益率为56%(18个中的10个)。稳定的疾病(<6个月)为17%(18个中的3个),另外2例被判断为进行性疾病。包括2个治疗在内的治疗失败时间中位数为5.6个月(范围为0.1到14.5())。尽管在接受长期治疗的患者中观察到阴道出血或子宫内膜增厚,但没有发生严重的不良事件,如深静脉血栓形成或其他恶性肿瘤。
结论:尽管尚未完全了解这种治疗的机制,但我们的数据可能有助于改变晚期内分泌治疗的普遍看法。

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