The Effect Of Letrozole Combined With Ibandronate In The Treatment Of Postmenopausal Metastatic Breast Cancer Patients

Objective:To research the effect and adverse reaction of letrozole combined with ibandronate in the treatment of postmenopausal breast cancer patients with bone metastases.Method:There are 42 patients all of whom are postmenopausal breast cancer patients with bone metastases. Patients were randomized to two groups. The 21 patients in treatment group were assigned to receive letrozole 2.5mg,po,qd and intravenous infusion of ibandroante 4mg add 500ml saline water or 5% glucose solution,every 4 weeks as a circle. The 21 patients in control group use letrozole alone in the same way. We make a comparison between the treatment group and control group by measuring the effect on the level of E2,the relief rates of pain,the improvement of the activity,the effect of the treatment of bone metastases,the KPS scores and the adverse reactions of the treatments after three circles treatment.Results:1. The comparison of the effect of the two groups.Treatment with letrozole suppressed plasma levels of E2 by a mean of 56.2% and 55.1% in two groups.The levels of E2 after the treatment in both groups were declined,and there was a significant difference in statistical analysis. But there was no differences between the two group. In terms of pain relief,pain treatment group overall response rate was 95.2% versus 52.4% in the control group. According to statistical analysis,there was a significant difference between these two groups(P<0.05). The activity improvement rate of the treatment group the was 90.5%, compared with 42.9% in the control group, there was also statistically significant difference between the two groups. The overall response rate of bone metastases was 42.9% in treatment group , compared with 14.3% in the control group, the difference was significant. The improvement of the KPS scores of the treatment group was on the average of 25 points, while the control group was 11 points, there was statistically significant difference between the two groups.The hypercalcemia could be controlled better in the treatment group than in the control group.2.Adverse reactions:The main adverse reactions were nausea, headache, fatigue, along with hectic fever, anorexia,chest pain, muscle and joint pain, bellyache, erythra, astriction, diarrhea, colporrhagia,all of these were mild to moderate.The patients could tolerate without special treatment.Conclusions:1. Letrozole is effective in the suppression of the estradiol level of ER and (or) PR positive metastatic breast cancer patients and effective in pain, lesion development control in patients with bone metastasis.2. Ibandronate can significantly reduced the hypercalcemia and the pain caused by bone metastasis and the other relevant events.3. Letrozole combined with ibandronate can significantly relieve the refractoriness pain and improve quality of life and physical condition.4. The use of letrozole is easy to use and the adverse reactions are mild.As a matter of fact,it can be accepted by most patients. So it can be used in maintenance treatment for the advanced breast cancer patients with positive receptors.