【指南】PPT--2014+ASCO临床指南激素受体阳性乳腺癌妇.pdf

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1、AdjuvantEndocrineTherapyforWomenwithHormoneReceptor-PositiveBreastCancerClinicalPracticeGuidelineUpdateguide.medlive.cnIntroduction•ASCOinitiallypublisheditsguidance(technologyassessment)fortheuseofendocrinetherapyintheadjuvantsettingforwomenwithhormonereceptor-positivebreastcancerin2002•ASCOgui

2、delinesareupdatedatintervalsbyanUpdateCommitteeoftheoriginalExpertPanel;thelastupdatewasin2010•Duetonewresultsonthedurationofadjuvanttamoxifen,anUpdateCommitteeconvenedforafocusedupdateofthisguideline•Forthecurrentupdate,theUpdateCommitteereviewedliteraturepublishedsinceJanuary2009www.asco.org/g

3、uidelines/©AmericanSocietyofClinicalOncology®.Allrightsreserved.guide.medlive.cnGuidelineMethodology:SystematicReview•TheUpdateCommitteecompletedasystematicreviewandanalysisofthemedicalliteratureJanuary2009throughMay2013MedlineSanAntonioBreastCancerconferenceproceedings(2011-2012)ASCOconferen

4、ceproceedings(2011-2013)3historicaltrialswww.asco.org/guidelines/©AmericanSocietyofClinicalOncology®.Allrightsreserved.guide.medlive.cnClinicalQuestions(1)Whichadjuvantendocrinetreatmentsshouldbeofferedtowomenwithhormonereceptor–positivebreastcancer?(2)Whatistheappropriatedurationofadjuvantendo

5、crinetherapy?(3)Whatistheappropriatesequenceofadjuvantendocrinetherapy?www.asco.org/guidelines/©AmericanSocietyofClinicalOncology®.Allrightsreserved.guide.medlive.cnRecommendationsWomenwhoarepre-orperimenopausalOptions:IA.Tamoxifenforaninitialdurationof5years.IB.After5years,womenshouldreceiveadd

6、itionaltherapybasedonmenopausalstatus.IB1.Ifwomenarepre-orperimenopausal,orifmenopausalstatusisunknownorcannotbedetermined,theyshouldbeofferedcontinuedtamoxifenforatotaldurationof10years.(Type:Evidence-Based,EvidenceQuality:High,StrengthofRecommendation:Strong)www.asco.org/guidelines/©AmericanSo

7、cietyofClinicalOncology®.Allrightsreserved.guide.medlive.cnRecommendationspre-orperimenopausal,continuedIB2.Ifwomenhavebecomedefinitivelypostmenopausal,theyshouldbeofferedcontinuedtamoxifenforatotaldurationof10yearsorswitchi