Aromatase inhibitors (AIs), with or without gonadotropin-releasing hormone analogs, are the cornerstone of adjuvant endocrine therapy for women with hormone receptor-positive early-stage breast cancer, offering significant reductions in recurrence risk and improving long-term survival. Their use is frequently accompanied by treatment-related toxicities that can adversely affect patients’ quality of life (QoL) and adherence to therapy. Commonly reported side effects include vasomotor symptoms, such as hot flashes; musculoskeletal disorders, such as arthralgia and myalgia; mood disorders; and genitourinary discomfort, such as vaginal dryness and dyspareunia. Additionally, AIs are associated with a heightened risk of bone loss, leading to osteoporosis and fractures, and may have implications for cardiovascular health. Effective management of these adverse events is pivotal in maintaining treatment adherence and preserving QoL. Evidence-based strategies to address these toxicities include pharmacological interventions, such as analgesics for joint pain, bisphosphonates or denosumab for bone health, and hormonal or non-hormonal approaches for vasomotor and genitourinary symptoms. Non-pharmacological measures, including physical activity, dietary adjustments, and complementary therapies, can also help mitigate symptoms. This review examines the broad spectrum of AI-associated toxicities, discusses their clinical implications, and provides an overview of evidence-based management strategies. These insights aim to support clinicians in optimizing patient care while minimizing the toxicities of therapy.
芳香化酶抑制剂（AIs），无论是否联合促性腺激素释放激素类似物，均是激素受体阳性早期乳腺癌女性辅助内分泌治疗的基石，可显著降低复发风险并改善长期生存。然而，其使用常伴随治疗相关毒性，可能对患者的生活质量及治疗依从性产生不利影响。常见报告的副作用包括血管舒缩症状（如潮热）、肌肉骨骼疾病（如关节痛和肌痛）、情绪障碍以及生殖泌尿系统不适（如阴道干燥和性交痛）。此外，芳香化酶抑制剂还与骨丢失风险增加相关，可能导致骨质疏松和骨折，并可能对心血管健康产生影响。有效管理这些不良事件对于维持治疗依从性和保护生活质量至关重要。针对这些毒性的循证管理策略包括药物干预，如使用镇痛药缓解关节疼痛、使用双膦酸盐或地舒单抗维护骨骼健康，以及采用激素或非激素方法处理血管舒缩症状和生殖泌尿系统症状。非药物措施，如体育活动、饮食调整和补充疗法，也有助于缓解症状。本综述系统梳理了芳香化酶抑制剂相关毒性的广泛谱系，探讨了其临床意义，并概述了基于证据的管理策略。这些见解旨在帮助临床医生在优化患者护理的同时，最大限度地降低治疗毒性。
肿瘤(癌症)患者之家