The left Bang better arm of mammary glands cancer treatment:Chemotherapy and endocrine cure

Chemotherapy and endocrine's cure is a mammary glands cancer currently the main treatment means of the Medicine, but chemotherapy and endocrine cure whether should unite an applied problem, has been being everyone to concern and issue of a little bit hot.In fact the noodles is two kinds of circumstances here, for this we must peg out first, is Shu behind prevent°from relapse to transfer of assistance treatment, or aim at to relapse to transfer a give relief to of focus a treatment.



The Shu prevent°froms relapse to transfer behind of the assistance cure



Be subjected to a patient to speak after the Shu of body(ER) masculine gender to the estrogen, three benzene oxygen the An(TAM) be currently to prevent°from relapse to transfer of standard ssistance treatment, if again add to use to neglect, then can lower to relapse rate and death rate further.Therefore, after the Shu of ER masculine gender patient if can bear these two kinds of words of treatments, will raise curative effect further.



As for chemotherapy and TAM how unite, is in the meantime to apply, alternation application, still preface Guan application, more than ten in the last yearses' aring international up also has been have a rift, we nation of the habit way of doing be in the meantime to apply or replace application.This had more explicit result on 2002 ASCO meeting.



We think TAM in the meantime applied period, may offset the function of chemotherapy medicine, after suggesting to need all chemotherapy be overs, again alone applied TAM, but the preface Guan applied advantage after need the long time just presents.



Up to now return no one to think, chemotherapy and TAM's being applied will compare preface Guan to cure to bring patient more advantages in the meantime.Even alternately carry on, stop using TAM in do that several days of chemotherapy, continue in the intermittent day of chemotherapy period applied, probably also not beneficial at the exaltation of curative effect.Take after the TAM for few hour, can immediately attain a blood plasma high peak density, and its half- life is for 7 days, need 5 each half- lifes then can chase medicine clearance clean, so even the chemotherapy stops using that several days and also just like apply in the meantime at the TAM and the chemotherapy.



So we suggest, to patient after the Shu of ER masculine gender, arrange 5 years or more long-playing TAM again after 6 foots with regular period measure of chemotherapy, so did to save a chemotherapy endocrine to cure in half year at least of expenses, from the health economics standpoint to see also reasonable.



As for the assistance put to treat a period to use need not TAM, our way of doings' aring chemotherapies is 6 periods →put to treat →TAM, after putting to treat again use TAM to avoid TAM to the disadvantageous influence which puts to treat.But some recent international cooperation researches think, project a treatment after all is a kind of part treatment, just continue of surgical operation and add.For promise the coherent of the whole body treatment, don't hope in the emanation to cure stage interruption whole body a treatment, past suggestion after the chemotherapy all is over, put to treat a period to start applied TAM.



If put to treat is add finished in the chemotherapy, for example the chemotherapy be 3 periods →put to treat →the preface Guan of chemotherapy 3 periods, TAM and chemotherapy carry on more difficult, the TAM which fears and puts to treat to accept in the meantime will influence after the chemotherapy curative effect of 3 periods.The assistance that 2000 United States establish cures the latest guideline suggestion and put to treat had better after Shu 6 completion inside months.If can promise after the Shu the chemotherapy period repeats every 21~28 days, put to treat to put to complete again after chemotherapy, is also not more than this term, so can also easy to chemotherapy and TAM preface Guan carry on.



Relapse to transfer a give relief to of focus a treatment



Chemotherapy and endocrine cure applied second circumstance of consociation BE, aim at to relapse to transfer a give relief to of focus a treatment.The reason that, a lot of doctors put forward the Qian stage dialogue which to apply in the meantime be, dare not believe the effect of endocrine treatment.But a great deal of cultural heritage report ways all express, the endocrine treatment is a kind of treatment means of independence.Be like to study currently most actively the 3rd generation fragrance turn Mao depressant similar, in spite of body of right and wrong Zi of come to song Shi, that song Shi, still the Zi body of depend on the west beautiful Tan, all successively experienced three lines to give relief to a treatment, two lines to give relief to a treatment before they appear on market, a glimmer of give relief to a treatment, new assistance treatment, is go to assistance treatment of nations have another central of big set the clinical trial be an all single medicine treatment and have no and chemotherapy suitable for use, end all get definitely efficient and clinical benefit a period.



Endocrine treatment in addition to curative effect definitely and outside, the biggest advantage is that the poisonous pair respond small, living quality Gao, Be probably and with long hours carry on making stronger a treatment.But if and chemotherapy suitable for use, the curative effect raised how much, but the advantage of endocrine treatment be almost exhausted broken.



See from existing data, these chemotherapy and endocrine cure in the meantime the project not essential treatment of suitable for use and also have no big religion to report.Aim at ER male or unidentified relapse to transfer a focus, we in times gone by don't approve chemotherapy and endocrine to cure to apply in the meantime, but actively initiate chemotherapy and endocrine treatment to have a plan, have a purpose and have consciously preface Guan an application.Ignore through a chemotherapy still an endocrine a treatment, if the pathological changes controled, remain the focus turned for the better again, can the preface Guan change to use another treatment.At new hand segment under medical treatment with do not control pathological changes as a target focus, according to the principle of "the effect be not more square, invalid necessarily change", hard track an observation, gradually the quest carry on.



Should what to notice BE, if the effect of ex- kind of treatment has been already attain, don't be in use another new treatment means again.Because invaluably the treatment effect of the new hand segment, the hard arrangement new hand segment use when end.This is that can postpone again to use original valid means and carry on making stronger a treatment;Otherwise stop cure, observation with visit.But new treatment means or project, use again while rather staying to relapse to transfer till next time.Same truth, we also don't approve to cut off or put to treat towards relapsing to transfer focus early and early, so would also because of losing a target focus, the correct implement of influence chemotherapy or endocrine treatment.



If can really masterly control this medicine principle and strategy of use of"touch the rock leading river", can also try out endocrine to cure for 1~2 month to the patient of ER feminine gender.Because the cultural heritage report that the patient of ER feminine gender can have 10% or below 5% of efficient;Certainly according to our own experience, the patient of ER feminine gender of efficient still far and far could not reach this level.But such as indeed there is necessity, can also pass an endocrine treatment, fight for one more to alleviate for these patients or clinical opportunity for benefit.



We finally want to emphasize, ignore to be an assistance treatment, or give relief to treatment, chemotherapy and endocrine to cure the left Bang better arm that is a mammary glands cancer treatment, can't be mutually exclusive, but should all synthesize a treatment of a part.But these two kinds of treatment meanses is not without principle of the heap add an application, but should be a way of thinking very clearly in the meantime preface Guan application, so then can well develop them the respectively biggest function.