Long-term safety and efficacy of a tamoxifen-based treatment strategy for idiopathic retroperitoneal fibrosis
| Autor: | H. van Damme, E. F. H. van Bommel, Tadek R. Hendriksz, L.G. Pelkmans |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Retroperitoneal fibrosis Internal Medicine medicine Humans Prospective Studies Idiopathic Retroperitoneal Fibrosis Prospective cohort study Aged business.industry Estrogen Antagonists Retroperitoneal Fibrosis Middle Aged medicine.disease Surgery Pulmonary embolism Tamoxifen Treatment Outcome Treatment strategy Observational study Female Long term safety medicine.symptom business Tomography X-Ray Computed medicine.drug Follow-Up Studies |
| Zdroj: | European journal of internal medicine. 24(5) |
| ISSN: | 1879-0828 |
| Popis: | Background Tamoxifen may be a viable treatment option for idiopathic retroperitoneal fibrosis (iRPF) but data are limited and its long-term safety and efficacy is unclear. We describe the long-term course and outcomes in a large group of patients with iRPF treated with tamoxifen monotherapy. Methods This is a single-center prospective, observational study of 55 patients with iRPF treated with tamoxifen for 2 years from April 1998 through April 2011. Measurements included clinical improvement, laboratory parameters and follow-up computed tomographic (CT) scanning. Treatment success was the composite endpoint of clinical improvement, mass regression and definite resolution of ureteral obstruction. Results Forty-seven (85%) patients reported substantial resolution of symptoms after median treatment duration of 3.0 weeks (IQR 1.4–4.8 weeks). Repeated CT scanning showed mass regression in 39 (71%) patients at 4 months and 47 (85%) patients at 8 months of follow-up, respectively. Nineteen (34.5%) patients did not meet the composite endpoint of treatment success, 56% of whom responded satisfactorily to second-line immunosuppressive treatment. Recurrence-free survival in patients with treatment success after post-treatment follow-up of 21 months (IQR 9.0–35.0 months) was 68%. Tamoxifen was well tolerated. Pulmonary embolism occurred in 2 patients receiving tamoxifen and in one patient receiving second-line treatment. Conclusion Tamoxifen is a safe and viable therapeutic option in the treatment of iRPF. |
| Databáze: | OpenAIRE |
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