乳腺癌骨转移药物治疗的疗效评价及分类处理
骨转移是乳腺癌患者最常见的全身播散性疾病，但预后明显好于内脏转移。实体瘤的疗效评价标准将骨转移病灶视为不可测量病灶，排除在新药临床试验之外。但是骨转移患者也迫切希望通过有效的抗乳腺癌药物治疗，推迟内脏转移的发生，延长生存时间。内分泌治疗是乳腺癌骨转移患者最重要的药物治疗手段。通过骨窗CT可以客观评价疗效。溶骨性或混合性转移患者，成骨增多为治疗好转，溶骨增多为疾病进展，应遵循＂效不更方，无效必改＂的原则指导用药。而成骨性转移是一种稳定修复的特殊类型，其中雌激素受体阳性者采用内分泌治疗，其他类型患者可以等待出现溶骨及内脏转移后再应用化疗和（或）抗人表皮生长因子受体2治疗。双膦酸盐只是在有效的抗乳腺...
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| Published in | 中华肿瘤杂志 Vol. 39; no. 3; pp. 161 - 165 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
军事医学科学院附属医院全军肿瘤中心, 北京,100071
2017
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0253-3766 |
| DOI | 10.3760/cma.j.issn.0253-3766.2017.03.001 |
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| Abstract | 骨转移是乳腺癌患者最常见的全身播散性疾病，但预后明显好于内脏转移。实体瘤的疗效评价标准将骨转移病灶视为不可测量病灶，排除在新药临床试验之外。但是骨转移患者也迫切希望通过有效的抗乳腺癌药物治疗，推迟内脏转移的发生，延长生存时间。内分泌治疗是乳腺癌骨转移患者最重要的药物治疗手段。通过骨窗CT可以客观评价疗效。溶骨性或混合性转移患者，成骨增多为治疗好转，溶骨增多为疾病进展，应遵循＂效不更方，无效必改＂的原则指导用药。而成骨性转移是一种稳定修复的特殊类型，其中雌激素受体阳性者采用内分泌治疗，其他类型患者可以等待出现溶骨及内脏转移后再应用化疗和（或）抗人表皮生长因子受体2治疗。双膦酸盐只是在有效的抗乳腺癌治疗前提下，推迟或减少骨相关事件的辅助药物，不应盲目滥用。 |
|---|---|
| AbstractList | 骨转移是乳腺癌患者最常见的全身播散性疾病，但预后明显好于内脏转移。实体瘤的疗效评价标准将骨转移病灶视为不可测量病灶，排除在新药临床试验之外。但是骨转移患者也迫切希望通过有效的抗乳腺癌药物治疗，推迟内脏转移的发生，延长生存时间。内分泌治疗是乳腺癌骨转移患者最重要的药物治疗手段。通过骨窗CT可以客观评价疗效。溶骨性或混合性转移患者，成骨增多为治疗好转，溶骨增多为疾病进展，应遵循＂效不更方，无效必改＂的原则指导用药。而成骨性转移是一种稳定修复的特殊类型，其中雌激素受体阳性者采用内分泌治疗，其他类型患者可以等待出现溶骨及内脏转移后再应用化疗和（或）抗人表皮生长因子受体2治疗。双膦酸盐只是在有效的抗乳腺癌治疗前提下，推迟或减少骨相关事件的辅助药物，不应盲目滥用。 骨转移是乳腺癌患者最常见的全身播散性疾病,但预后明显好于内脏转移.实体瘤的疗效评价标准将骨转移病灶视为不可测量病灶,排除在新药临床试验之外.但是骨转移患者也迫切希望通过有效的抗乳腺癌药物治疗,推迟内脏转移的发生,延长生存时间.内分泌治疗是乳腺癌骨转移患者最重要的药物治疗手段.通过骨窗CT可以客观评价疗效.溶骨性或混合性转移患者,成骨增多为治疗好转,溶骨增多为疾病进展,应遵循"效不更方,无效必改"的原则指导用药.而成骨性转移是一种稳定修复的特殊类型,其中雌激素受体阳性者采用内分泌治疗,其他类型患者可以等待出现溶骨及内脏转移后再应用化疗和(或)抗人表皮生长因子受体2治疗.双膦酸盐只是在有效的抗乳腺癌治疗前提下,推迟或减少骨相关事件的辅助药物,不应盲目滥用. |
| Abstract_FL | Skeleton is one of the most common metastatic organs for breast cancer, which has a better prognosis than visceral metastases. Bone-only metastasis was defined"non-measurable" in the RECIST ( Response Evaluation Criteria in Solid Tumors ) criteria, and was excluded by clinical trials. However, patients with bone-only metastasis are also in need of effective treatment to prolong survival. Endocrine therapy is the most important treatment for bone metastatic patients. Tumor response of bone metastases can be determined objectively by bone-window CT. Effective treatment should be continued if the symptoms are relieved or osteogenesis is observed. Osteoblastic change in bone-window CT is a sign of improvement after treatment. Endocrine therapy is proper for ER-positive patients. The patients with initial osteoblastic metastasis should not be treated with salvage chemotherapy or anti-HER2 treatment, only if osteolytic metastasis or visceral metastasis is observed. Bishosphonates are just auxiliary drugs in bone metastasis, which should not be abused. |
| Author | 孟祥颖 宋三泰 |
| AuthorAffiliation | 军事医学科学院附属医院全军肿瘤中心,北京100071 |
| AuthorAffiliation_xml | – name: 军事医学科学院附属医院全军肿瘤中心, 北京,100071 |
| Author_FL | Song Santai Meng Xiangying |
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| Author_xml | – sequence: 1 fullname: 孟祥颖 宋三泰 |
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| DocumentTitleAlternate | Evaluation and classification of drug therapy for breast cancer with bone-only metastasis |
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| Keywords | Treatment outcome 乳腺肿瘤 药物疗法 治疗结果 Neoplasms metastasis,bone 肿瘤转移,骨 Breast neoplasms Drug therapy |
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| Notes | Skeleton is one of the most common metastatic organs for breast cancer, which has a better prognosis than visceral metastases. Bone-only metastasis was defined ＂non-measurable＂ in the RECIST （Response Evaluation Criteria in Solid Tumors ） criteria, and was excluded by clinical trials. However, patients with bone-only metastasis are also in need of effective treatment to prolong survival. Endocrine therapy is the most important treatment for bone metastatic patients. Tumor response of bone metastases can be determined objectively by bone-window CT. Effective treatment should be continued if the symptoms are relieved or osteogenesis is observed. Osteoblastic change in bone-window CT is a sign of improvement after treatment. Endocrine therapy is proper for ER-positive patients. The patients with initial osteoblastic metastasis should not be treated with salvage chemotherapy or anti-HER2 treatment, only if osteolytic metastasis or visceral metastasis is observed. Bishosphonates are just auxiliary drugs in bone me |
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| SubjectTerms | 乳腺肿瘤 治疗结果 肿瘤转移 药物疗法 骨 |
| Title | 乳腺癌骨转移药物治疗的疗效评价及分类处理 |
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