WHAT DO WE KNOW AND WHAT DONT WE KNOW ABOUT TAMOXIFEN IN THE HUMAN UTERUS

被引:52
作者
FRIEDL, A
JORDAN, VC
机构
[1] UNIV WISCONSIN, CTR MED SCI, DEPT PATHOL & LAB MED, MADISON, WI 53706 USA
[2] UNIV WISCONSIN, CTR COMPREHENS CANC, DEPT HUMAN ONCOL, MADISON, WI 53792 USA
关键词
ANTIESTROGEN; BREAST CANCER; ENDOMETRIAL CARCINOMA; ENDOMETRIUM; TAMOXIFEN; UTERUS;
D O I
10.1007/BF00689674
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Since its introduction in the early seventies, the list of indications for the use of the antiestrogen tamoxifen has been continuously expanded. Tamoxifen is now used for the treatment of metastatic breast cancer and for long-term and often indefinite administration as an adjuvant therapy. Large clinical trials in three countries are now evaluating the efficacy of tamoxifen as a preventive agent. However, tamoxifen therapy has been associated with an increased incidence of endometrial carcinoma. Laboratory and clinical data available to date on this controversial issue can be summarized as follows: a) Tamoxifen can have an estrogenic effect on endometrium in the presence of low estrogen levels. b) Tamoxifen treatment is probably associated with an increased incidence of endometrial cancer; however, this association appears to be linked to higher tamoxifen doses (40mg/d). d) It is not known whether tamoxifen causes or allows the identification of occult endometrial carcinoma. e) At the present time there is evidence for a tumor promoting effect of tamoxifen on endometrial cancer at a dose of 20 mg per day. f) Replacement of tamoxifen by 'pure' antiestrogens or coadministration of progestins with tamoxifen do not appear to offer benefit unless clinical trials demonstrate a reduced incidence of endometrial problems. g) Patients must be evaluated for pre-exsisting endometrical carcinoma before starting tamoxifen therapy. f) Close followup of long-term tamoxifen patients with endometrial biopsies is recommended with individuals who experience symptoms.
引用
收藏
页码:27 / 39
页数:13
相关论文
共 87 条
[1]   INCIDENCE OF NEW PRIMARY CANCERS AFTER ADJUVANT TAMOXIFEN THERAPY AND RADIOTHERAPY FOR EARLY BREAST-CANCER [J].
ANDERSSON, M ;
STORM, HH ;
MOURIDSEN, HT .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1991, 83 (14) :1013-1017
[2]  
ANZAI Y, 1989, CANCER RES, V49, P2362
[3]   4 CASE-REPORTS PRESENTING NEW ACQUISITIONS ON THE ASSOCIATION BETWEEN BREAST AND ENDOMETRIAL CARCINOMA [J].
ATLANTE, G ;
POZZI, M ;
VINCENZONI, C ;
VOCATURO, G .
GYNECOLOGIC ONCOLOGY, 1990, 37 (03) :378-380
[4]   LIPOPHILIC IMPURITIES, NOT PHENOLSULFONPHTHALEIN, ACCOUNT FOR THE ESTROGENIC ACTIVITY IN COMMERCIAL PREPARATIONS OF PHENOL RED [J].
BINDAL, RD ;
CARLSON, KE ;
KATZENELLENBOGEN, BS ;
KATZENELLENBOGEN, JA .
JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY, 1988, 31 (03) :287-293
[5]  
BOCCARDO F, 1981, ONCOLOGY, V38, P281, DOI 10.1159/000225571
[6]   TAMOXIFEN AS A POSSIBLE CHEMOTHERAPEUTIC AGENT IN ENDOMETRIAL ADENOCARCINOMA [J].
BONTE, J ;
IDE, P ;
BILLIET, G ;
WYNANTS, P .
GYNECOLOGIC ONCOLOGY, 1981, 11 (02) :140-161
[7]   HORMONE-TREATMENT OF STROMAL ENDOMETRIOSIS [J].
BRONS, J ;
JENSEN, LK ;
RASMUSSEN, J .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 1980, 59 (05) :471-473
[8]  
BRUN LD, 1986, CANCER, V57, P2123, DOI 10.1002/1097-0142(19860601)57:11<2123::AID-CNCR2820571106>3.0.CO
[9]  
2-2
[10]   TAMOXIFEN AND ENDOMETRIOSIS - CASE-REPORT [J].
BUCKLEY, CH .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1990, 97 (07) :645-646