發(fā)布時(shí)間：2018-02-02 19:52

  本文關(guān)鍵詞： 乳腺癌 腦轉(zhuǎn)移 藥物治療 激素受體陽(yáng)性乳腺癌 綜述文獻(xiàn)　出處：《中華腫瘤防治雜志》2017年08期 　論文類(lèi)型：期刊論文

【摘要】：目的乳腺癌是僅次于肺癌最易發(fā)生腦轉(zhuǎn)移的原發(fā)腫瘤。激素受體陽(yáng)性乳腺癌是轉(zhuǎn)移性乳腺癌的主體,腦轉(zhuǎn)移是該類(lèi)患者的主要死亡原因,但目前對(duì)于激素受體陽(yáng)性乳腺癌腦轉(zhuǎn)移(breast cancer brain metastases,BCBM)的有效治療報(bào)道較少。本研究旨探討激素受體陽(yáng)性BCBM藥物治療的相關(guān)研究進(jìn)展。方法應(yīng)用PubMed及CNKI期刊全文數(shù)據(jù)庫(kù)檢索系統(tǒng),以"乳腺癌、腦轉(zhuǎn)移和激素受體陽(yáng)性乳腺癌"等為關(guān)鍵詞,檢索2005-01-2016-06相關(guān)文獻(xiàn),共檢測(cè)到中文文獻(xiàn)128條,英文文獻(xiàn)55條。納入標(biāo)準(zhǔn):1)BCBM的危險(xiǎn)因素及其預(yù)后;2)BCBM的當(dāng)前治療選擇;3)激素受體陽(yáng)性BCBM藥物治療。根據(jù)納入標(biāo)準(zhǔn),符合分析的文獻(xiàn)25篇。結(jié)果限制BCBM藥物治療進(jìn)展的主要原因是血腦屏障的存在。激素在BCBM治療中的療效尚不明確,但有大量個(gè)案報(bào)道他莫昔芬等內(nèi)分泌藥物對(duì)BCBM治療有效。非對(duì)照試驗(yàn)表明某些細(xì)胞毒類(lèi)藥物,如卡培他濱、替莫唑胺(temozolomide,TMZ)和卡莫司汀晶片植入劑,對(duì)激素受體陽(yáng)性BCBM有效,但沒(méi)有足夠證據(jù)支持具體的治療方案。免疫抑制劑abemaciclib在激素受體陽(yáng)性BCBM患者中的應(yīng)用正處于Ⅱ期臨床試驗(yàn)階段。雖然高分子藥物難以通過(guò)完整的血腦屏障,但研究證實(shí)部分單克隆抗體,如曲妥珠單抗和貝伐單抗,對(duì)BCBM治療有效。納米藥物傳遞系統(tǒng)能提高中樞神經(jīng)系統(tǒng)藥物轉(zhuǎn)移,有較好發(fā)展前景。由納米顆粒包裹的多柔比星和etirinotecan pegol對(duì)治療激素受體陽(yáng)性BCBM有一定的療效。結(jié)論盡管目前沒(méi)有專門(mén)批準(zhǔn)用于激素受體陽(yáng)性BCBM系統(tǒng)治療的藥物,但有大量的臨床試驗(yàn)正在進(jìn)行中,將為臨床治療帶來(lái)啟示。
[Abstract]:Objective Breast cancer is the primary tumor which is the most prone to brain metastasis after lung cancer. Hormone receptor positive breast cancer is the main body of metastatic breast cancer. Brain metastasis is the main cause of death in this kind of patients. But at present, for hormone receptor-positive breast cancer, brain metastases of breast cancer brain metastases. The purpose of this study was to investigate the related research progress of hormone receptor positive BCBM drug therapy. Methods PubMed and CNKI periodical full-text database retrieval system were used. Using "Breast Cancer, brain Metastasis and hormone receptor positive Breast Cancer" as the key words, a total of 128 articles were found in Chinese literature from January to June 2016-2005. 55 articles of English literature. The risk factors and prognosis of BCBM were included. 2the current treatment choice of BCBM; 3) steroid receptor positive BCBM drug therapy. According to inclusion criteria. Results the main reason for limiting the progress of drug therapy for BCBM was the existence of blood-brain barrier. The effect of hormone on BCBM was not clear. However, a large number of cases have reported that tamoxifen and other endocrine drugs are effective in the treatment of BCBM. Non-control trials have shown that some cytotoxic drugs, such as capecitabine, temozolomide, temozolomide. TMZ) and carmosine chip implants were effective for hormone receptor positive BCBM. But there is not enough evidence to support the specific treatment plan. The application of immunosuppressant abemaciclib in steroid receptor positive BCBM patients is in the phase 鈪，

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