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作者以大剂量甲地孕酮(High dose-Megestrol acetate HD—MA)500～1000 mg/日,或已酸羟孕酮(Hydroxyprogesterone capronte HD—HPC)500mg/日治疗17例晚期乳腺癌患者。结果HD—MA组8例中4例获PR,其中2例仍在缓解中,缓解期为45～362天(平均184天)。HD—HPC组9例中5例PR,缓解期为105～519天(平均282天)。软组织和内脏病变的疗效似胜于骨转移。经先期三苯氧胺(Tamoxifen)治疗失败的14例中,7例仍可因HD—MA或HD—HPC而缓解。除1例外,PR者均属绝经期后病人。HD—MA和HD—HPC可显著改善生活质量;多数患者疼痛明显减轻或消失,食欲改善,体重增加,KPS提高25％(MA组)或41％( HPC组)。未见其他明显的毒副反应。作者认为,HD—MA和HD—HPC作为第二线内分泌治疗手段,对于晚期、复发或难治性乳腺癌是安全、有效並有其独具的优点的。
The authors treated 17 patients with advanced breast cancer with High dose-Megestrol acetate HD-MA 500-1000 mg/day or Hydroxyprogesterone capronte HD-HPC 500 mg/day. Results 4 out of 8 patients in the HD-MA group received PR, and 2 of them were still in remission. The remission period was 45-362 days (mean, 184 days). In the HD-HPC group, there were 5 cases of PR in 9 cases and the remission period was 105 to 519 days (an average of 282 days). The efficacy of soft tissue and visceral lesions seems to be superior to bone metastases. Of the 14 patients who failed prior treatment with tamoxifen, 7 were still relieved by HD-MA or HD-HPC. With one exception, PR patients were post-menopausal patients. HD-MA and HD-HPC significantly improved quality of life; most patients experienced pain relief or disappearance, improved appetite, and weight gain, with KPS increased by 25% (MA group) or 41% (HPC group). No other obvious toxicities were seen. The authors believe that HD-MA and HD-HPC as second-line endocrine therapy are safe, effective and have unique advantages for advanced, relapsed or refractory breast cancer.