乳腺癌患者在接受手术或化疗后，常被要求继续服用名为“它莫西芬”的药物以防复发。但由于这种药有副作用，许多患者往往不按医嘱，擅自停药。英国一项新研究显示，停药将增大患者癌症复发和死亡的风险。
英国苏格兰格拉斯哥大学研究人员在《英国癌症期刊》上报告说，他们对1263名乳腺癌患者的处方记录和服药情况进行了跟踪调查，发现一些患者因为出现潮热、关节痛、疲惫或体重增加等副作用，没有按医生要求坚持服用它莫西芬。
研究人员将按期服药率不足80％的患者认定为“对坚持治疗配合度低”，并分析了她们的癌症复发风险。研究显示，未坚持服药的人群癌症复发和死亡风险都更高，而且因住院治疗或服用其他药物，她们需要负担人均近6000英镑的额外支出。
研究人员说，英国每年约有1．3万名乳腺癌患者被医生要求连续5年服用它莫西芬，但许多患者因副作用擅自停药，由此造成的不必要死亡病例估计每年超过430例，额外支出高达数百万英镑。
英国“乳腺癌运动”组织首席执行官摩根说，它莫西芬药效显著，但可能在部分人群中引发副作用。这项研究一方面提醒患者，应坚持按医嘱服药；另一方面也告诫医生，应帮助患者坚持服药，并尽量克服可能出现的副作用。（生物谷Bioon.com）
生物谷推荐的英文摘要
British Journal of Cancer doi:10.1038/bjc.2013.116
Cohort study of adherence to adjuvant endocrine therapy， breast cancer recurrence and mortality
B Makubate1， P T Donnan2， J A Dewar3， A M Thompson3 and C McCowan4
Background：
Adjuvant endocrine therapy is recommended for women with oestrogen receptor-positive breast cancer， but many women do not take the medication as directed and they stop treatment before completing the standard 5-year duration.
Methods：
This retrospective cohort study conducted between 1993 and 2008 of all women with incident breast cancer， who are residing in the Tayside region of Scotland， examined adherence to prescribed adjuvant tamoxifen or aromatase inhibitors (AIs). Survival analysis examined the effect of adherence on all-cause mortality， breast cancer death and recurrence， using linked prescribing， cancer registry， clinical cancer audit， hospital discharge and death records.
Results：
A total of 3361 women with breast cancer were followed for a median 4.47 years (interquartile range (IQR)=2.04–8.55). The median overall adherence was 90% (IQR=90–100%)， but the annual adherence reduced after a longer period from diagnosis. Low adherence of <80% was associated with poorer survival (hazard ratios=1.20； 95% confidence interval=1.03–1.40， P=0.019). There was no significant difference for low adherence over the treatment period and recurrence， or breast cancer death， but patients with high annual adherence for 5 years had better outcomes than those with 3 or less.
Conclusion：
Low adherence to all adjuvant endocrine therapy for women with breast cancer， whether tamoxifen or AI， increases the risk of death.
