激素治疗可预测女性肺癌患者生存期延长

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激素治疗可预测女性肺癌患者生存期延长Hormone therapy predicted improved lung cancer survival in women
来源：爱思唯尔2014-03-10 09:30点击次数：179发表评论分享到

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美国Karmano肿瘤研究所、韦恩州立大学的Ann G. Schwartz博士及其合作者在3月份的《胸科肿瘤杂志》(Journal of Thoracic Oncology)上报告，激素治疗与女性非小细胞肺癌患者总生存期延长相关。长期使用激素和联合使用雌孕激素可预测最显著的生存期获益。

女性肺癌患者的生存期通常较男性患者更长。但之前仅有少数研究评估了生殖因素、激素治疗与肺癌预后之间的相关性，并且结果不一致(J. Thorac. Oncol. 2014;9:355-61)。

研究者访问了2001~2005年间诊断为非小细胞肺癌的485例女性患者，询问其生育史以及激素治疗的类型、剂量和持续时间。

结果显示，校正诊断时分期、手术、放疗、教育水平、烟草暴露、年龄和种族等因素的影响后，发现仅激素治疗可预测总生存期［危险比（HR）为0.69；95%可信区间为0.54~0.89］。在诊断肺癌之前接受激素治疗的女性中位生存期为80个月，而诊断前未接受激素治疗的女性中位生存期为37.5个月。当激素治疗持续≥11年时，生存益处最显著，尤其是联合使用雌激素和孕激素的治疗（HR为0.50；95% CI为0.30~0.83） 。接受雌激素治疗不足11年对生存期无显著影响。

该研究结论为，长期雌孕激素治疗可预测女性非小细胞肺癌患者总生存期延长。

该研究由国立卫生研究院资助。作者披露无相关利益冲突。

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By: AMY KARON, Internal Medicine News Digital Network

Hormone therapy was associated with improved overall survival in women with non–small-cell lung carcinoma, reported investigators in the March issue of the Journal of Thoracic Oncology.

Long-term hormone use and combinations of estrogen and progesterone predicted the most significant survival benefit, reported Dr. Ann G. Schwartz of the Karmanos Cancer Institute and Wayne State University, both in Detroit, and her associates.

Women with lung cancer usually live longer than do men with the disease. But few prior studies have examined associations between reproductive factors, hormone therapy, and lung cancer outcomes, and results have been inconsistent, investigators said (J. Thorac. Oncol. 2014;9:355-61).

Researchers interviewed 485 women who were diagnosed with non–small-cell lung carcinoma between 2001 and 2005, about their reproductive histories and type, dose, and duration of hormone therapy.

Only hormone therapy predicted overall survival (hazard ratio, 0.69; 95% confidence interval, 0.54-0.89) after accounting for stage at diagnosis, surgery, radiation, education level, cigarette smoke exposure, age, and race, the investigators reported.

Women who received hormone therapy prior to lung cancer diagnosis survived a median of 80 months, compared with 37.5 months for women who did not.

The survival benefit was most significant when hormone therapy lasted 11 years or longer, particularly for combinations of estrogen and progesterone (HR, 0.50; 95% CI, 0.30-0.83). Taking estrogen alone for less than 11 years had no significant effect.

Because patients had to be healthy enough to participate in the survey, results might not apply to all women with non–small-cell lung cancer, Dr. Schwartz and associates noted.

"These findings suggest a complex relationship between exposure to exogenous hormones and lung cancer outcomes," added the researchers. They recommended research to explore the biological reasons for their findings.

This study was supported by the National Institutes of Health. The authors disclosed no relevant financial conflicts of interest.