Résumé
PURPOSE: Published Early Breast Cancer Trialists' Collaborative Group overview results have been the beneficial effects of tamoxifen and ovarian ablation for pre and perimenopausal women with node negative breast cancer. Chemotherapy and Luteinizing Hormone Releasing Hormone (LHRH) agonists (medical ovarian ablation) have been shown to be effective adjuvant therapies for early stage breast cancer in several clinical trials however, the efficacy and tolerance of LHRH agonists in Korean breast cancer patients has not been evaluated. METHODS: Three thousand one hundred fifty breast cancer patients were treated at Asan Medical Center between January 2003 and December 2005. We selected 185 patients with node negative early breast cancer who were endocrine responsive (more than intermediate intensity), with a tumor size more than 1 cm, and who were reluctant to undergo chemotherapy due to the side effects. They received LHRH agonists (Zoladex(R) 3.6 mg) every 28 days with tamoxifen for two years. We prospectively evaluated mammography, chest PA, and physical examination every six months and evaluated the side effects and quality of life. RESULTS: The mean age was 43.5 yr, and the mean tumor size was 1.62 cm. One hundred sixty-two patients had Stage I, and 23 Stage II disease. The incidence of severe menopausal symptoms was 24.1%, but these symptoms were reported to be "tolerable" during the two year follow-up. Quality of life and physical activity were essentially unchanged. The median follow-up duration was 18 months, and there was no local recurrence or distant metastases during the study. CONCLUSION: Adjuvant therapy with LHRH agonists is safe and tolerable, and may be an alternative to chemotherapy for pre-and perimenopausal women with hormone responsive early breast cancer who are reluctant to undergo chemotherpy.
Sujets)
Femelle , Humains , Tumeurs du sein , Région mammaire , Traitement médicamenteux , Études de suivi , Hormone de libération des gonadotrophines , Incidence , Mammographie , Activité motrice , Métastase tumorale , Examen physique , Études prospectives , Qualité de vie , Récidive , Tamoxifène , ThoraxRésumé
The decidua of pseudopregnant rats and of those effected by high dosage of luteinizing hormone-releasing hormone analogue (LH-RH-A) were studied histologically.After inducement of pseudopregnancy, 29 Wistar virgin rats were divided into experimental and control groups. The experimental group was injected with 200?g. of LH-RH-A subcutaneously daily for four days, while to the control group, physiological saline was injected instead. Both experimental and control animals were killed on the 9th, 11th and 13th day of pseudopregnancy.The uteri were fixed with appropriate fixatives and paraffin sections were processed with HE, phloxine-tartrazine, Foots and aldehyde fuchsin staihing methods.On the 9th day decidua of the control rats are well developed with many endometrial granulated cells, while in the decidua of the experimental group, the decidual cells become pyknotic, and the granulated cells are barely seen. The results suggest that a high dosage of LH-RH-A advances the necrosis of decidua of the pseudopregnant rats.
Résumé
The specific anti-rat LH, anti-rat FSH and anti-hCG sera were used in the peroxidase antiperoxidase (PAP) immunohistochemical method to observe the change of pituitary gonadotropic cells in pregnant rats after being injected by a high dosage of LHRH-A. It was observed that 24 hrs after injection the immunohistochemical reaction of gonadotropic cells weakened strikingly; 48 hrs after injection the immunohistochemical reaction began to recover; and 168 hrs after injection, the recovery was still in progress. The number of LH cells of different immunoreactive intensity and their percentage in total LH cells of the control and experimental groups were calculated and tested by statistical method. It was found that the results were the same as the above. Our observations support the view that the high dosage of LHRH-A can stimulate gonadotropic cells in rat to release a great amount of LH rapidly. It inhibits the synthesis of progesterone in the ovary of pregnant rat and results in termination of pregnancy. Moreover it is believed that the effect of high dosage of LHRH-A on the secretory function of gonadotropic cells can recover themseleves.
Résumé
29 virgin female Wistar rats were divided into experimental and control groupson the 5th day of pseudopregnancy.The experimental animals were injected with200 ?g.of LH-RH-A subcutaneously daily in 5th-8th day,while in the controlgroup physiological saline was used instead.Both experimental and control animalswere killed on 9th,11th,13th days of pseudopregnancy.Histochemical techniques were applied to cryostat sections to show the activityof the following enzymes:SDH,LDH,NE,~5△A-3?-HSD,G6Pase,TPPase,AlPand AcP;PAS,Oil red O,and gallocyanin-chromalum staining methods were usedto show carbohydrates,fats and RNA respectively.The above enzymatic reactions of the decidual cells of the experimental animalswere negative,while those of the stromal cells were positive on 9th day.Incomparison,the results of the decidua of the control group on 13th day are verysimilar to the decidua of the experimental group on the 9th day.The resultssuggest that a high dosage of LH-RH-A only advances degeneration of thedecidua.