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Skeletal events of Anastrozole versus Tamoxifen on bone mineral density and bone biomarker osteocalcin in postmenopausal women with early breast cancer

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The Chinese-German Journal of Clinical Oncology 2010年第10期9卷 574-578页

作者： Lobna R Ezz Elarab menha swellam Manal M Abdel Wahab Karima M Maher Radiation Oncology & Nuclear Medicine Faculty of MedicineAin Shams University Biochemistry Department Genetic Engineering and Biotechnology Research DivisionNational Research Center Radiology Department Faculty of MedicineAin Shams University

Objective： Postmenopausal women with breast cancer are at increased risk of bone loss because of age related estrogen deficiency face which accelerated with the use of aromatase inhibitors （AIs）. We aimed to study the effect on bone mineral density （BMD） and bone formation biomarker osteocalcin level in postmenopausal breast cancer patients, for the first three years of adjuvant hormonal treatment of both groups Tamoxifen versus Anastrozol. Methods： One-hundered postmenopausal breast cancers were prospectively randomized to receive either Tamoxifen 20 rag/day （n = 50） or Anastrozole 10 mg （n = 50）. Both BMD and osteocalcin were assessed initially before treatment and then at regular intervals for both groups. Results： Use of Tamoxifen was associated with significant annual decrease in osteocalcin （P = 0.001）, whereas Anastrozole group had gradual increase of the annual levels （P 〈 0.01）. BMD decreased significantly in Anastrozole versus Tamoxifen groups （2.6% vs. 0.4%, P 〈 0.001）. Osteoporosis T 〈 -2.5 was reported significantly higher in Anastrozole group （P 〈 0.01）. Women with initial osteopenia in Anastrozole group showed significant decrease in BMD （P 〈 0.05）. The addition of bisphosphonate for patients with early osteoporosis markedly improved both osteocalcin level and BMD. Conclusion： Tamoxifen preserves BMD in postmenopausal breast cancer patients, whereas Anastrozole accelerates age associated fall in BMD especially in the first year of therapy, moreover, the addition of bisphosphonate can help to decrease the skeletal related events associated with treatment to ensure better quality of life with treatment.

关键词： Anastrozole Tamoxifen, bone mineral density (BMD) breast cancer osteocalcin

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Assessment of maintenance oral Etoposide following induction chemotherapy with gemcitabine and cisplating in chemonaive extensive small cell lung cancer

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The Chinese-German Journal of Clinical Oncology 2010年第10期9卷 569-573页

作者： Lobna R Ezz Elarab Manal M Abdel Wahab menha swellam Zakaria Mostafa Radiation Oncology&Nuclear Medicine Faculty of MedicineAin Shams University Biochemistry Department Genetic Engineering and Biotechnology Research DivisionNational Research Center Abbasia Chest Hospital

Objective： The aim of our study was to evaluate the response and tolerability to treatment when using gemcitabine-cisplatin combination （GC）, followed by maintenance therapy of oral etoposide for non-progressive patients in trial to improve progression free survival and overall survival. Methods： Thirty nine patients with extensive small cell lung cancer （SCLC） and ECOG ≤ 2 received 4 cycles of chemotherapy consisting of gemcitabine 1000 mg/m^2 （day 1 and 8） cisplating 75 mgim2 （day 1） every three weeks. Twenty seven non-progressive patients after 4 cycles of chemotherapy were randomized either to receive oral etoposide 50 mg/m^2 for consecutive 15 days every 3 weeks vs no therapy for three months or progression. Results： Thirty nine eligible patients treated with GC, 27 non progressive patients were subsequently randomized to oral etoposide or observation. Median follow-up was 18 months. The overall response rate to GC was 59% and toxicity to oral etoposide was mild. There was improvement in median progression-free survival （PFS） favoring the maintenance arm of 10.5 months vs 7 months （P 〈 0.05）. Median overall survival （OS） had improved towards the maintenance arm （13 vs 11.5 months）. One year survival （60% vs 24%）, 18 months survival （20% vs 5%） favoring the maintenance. Multivariate analysis revealed that age, performance status, maintenance therapy, and response to treatment were independent prognostic factors for OS. Age, maintenance therapy, and response to treatment were highly significant factors for PFS. Conclusion： Gemcitabine-cisplatin is an effective and tolerable regiment for extensive disease of SCLC. The addition of 3 months of oral etoposide in non progressing patients was associated with a significant improvement of PFS and longer OS.

关键词： gemcitabine cisplatin small cell lung cancer

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