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目的评估芳香化酶抑制剂(aromatase inhibitors,AIs)应用于绝经后激素依赖性乳腺癌患者新辅助内分泌治疗的效果及安全性。方法计算机检索Cochrane图书馆、Pub Med、CNKI及CBMdisc等数据库,按既定标准纳入芳香化酶抑制剂应用于新辅助内分泌治疗的随机对照试验,以Cochrane系统进行逐篇质量评价,提取资料,并采用Rev Man 5.0软件进行Meta分析。结果共纳入9个随机对照试验,合计1 512名患者。结果显示:1在绝经后激素依赖性乳腺癌患者的新辅助内分泌治疗中,AIs在总有效率和完全缓解率上均优于雌激素受体阻滞剂;2在绝经后激素依赖性乳腺癌患者中,使用AIs的新辅助内分泌治疗效果与新辅助化疗相当;3新辅助化疗结合新辅助内分泌治疗对于绝经后激素依赖性乳腺癌患者可能有更好的近期疗效,但因研究太少,论证强度不高;4相对于细胞毒性药物,AIs和他莫昔芬的毒副反应发生率都较低,症状也较轻。结论 AIs可以作为绝经后激素依赖性乳腺癌患者新辅助内分泌治疗的一个安全、有效的治疗方案。
Objective To evaluate the efficacy and safety of aromatase inhibitors (AIs) for neoadjuvant endocrine therapy in postmenopausal women with hormone-dependent breast cancer. Methods The databases of Cochrane Library, Pub Med, CNKI and CBMdisc were searched by computer. A randomized controlled trial of aromatase inhibitors for neoadjuvant endocrine therapy was included according to established criteria. The Cochrane system was used to evaluate the quality of each part of the data. Data were extracted and used Rev Man 5.0 software for meta-analysis. Results A total of 9 randomized controlled trials were included, totaling 1 512 patients. The results showed that: 1 in the neoadjuvant endocrine therapy of postmenopausal hormone-dependent breast cancer patients, AIs are superior to estrogen receptor blockers in the total effective rate and complete remission rate; 2 in postmenopausal hormone-dependent breast cancer In patients, neoadjuvant endocrine therapy with AIs is comparable to neoadjuvant chemotherapy; 3 Neoadjuvant chemotherapy with neoadjuvant endocrine therapy may have better immediate effects in postmenopausal hormone-dependent breast cancer patients, but due to too little research, Intensity is not high; 4 Relative to cytotoxic drugs, AIs and tamoxifen have a lower incidence of adverse reactions, symptoms are mild. Conclusion AIs can be used as a safe and effective treatment for neoadjuvant endocrine therapy in patients with postmenopausal hormone-dependent breast cancer.