背景：一些研究显示，芳香化酶抑制剂（AI）作为激素受体（HR）阳性乳腺癌（BC）患者一线治疗的优越性。对于临床医生来说，有必要进行真实世界的研究，以确定基于每种药物的疗效进行治疗的治疗法。我们比较了每种AI的5年无病生存（DFS）情况。 材料和方法：我们评估了2019年1月至12月在Dr. Sardjito综合医院被诊断为HR阳性HER2阴性BC（I-III期）的450名绝经后妇女的病历。所有患者均接受了手术和化疗或放疗。此外，研究参与者至少连续服用阿那曲唑、来曲唑或异曲肼一年。我们使用Kaplan-Meier生存曲线来分析生存率。 结果：符合纳入标准的79名患者中，有21.52%的远处转移病例记录。阿那曲唑、来曲唑和异曲肼的疾病进展时间分别为49个月、58个月和53个月。发现来曲唑优于阿那曲唑（风险比（HR）= 4.342，95% CI 0.95-19.95；p = 0.038）。发现来曲唑与异曲肼（HR = 2.757，95% CI 0.53-14.33；p = 0.206）以及阿那曲唑与异曲肼（HR = 1.652，95% CI 0.56-4.84；p = 0.351）之间无显著差异。来曲唑的5年DFS率（87.5%）优于异曲肼（73.7%）和阿那曲唑（61.4%）。 结论：可以提出5年来曲唑治疗作为HR阳性HER2阴性BC绝经后妇女的一线治疗方案。需要进行大样本和长期随访来验证。版权所有©2023年德黑兰医科大学。

Background: Several studies showed the superiority of aromatase inhibitor (AI) as first-line therapy for patients with hormone-receptor (HR)-positive breast cancer (BC). For the clinician, studies in the real world are warranted to determine treatment based on the efficacy of each drug. We compared a 5-y disease-free survival (DFS) of each AI in terms of survival benefit. Materials and Methods: We evaluated 450 medical records of postmenopausal women who were diagnosed with HR-positive HER2-negative BC (stage I - III) at Dr. Sardjito General Hospital from January to December 2019. All patients had undergone surgery and chemotherapy or radiation therapy. Moreover, study participants received anastrozole, letrozole, or exemestane for at least one year. Kaplan Meier estimation survival curve was used to analyze the survival rate. Result: Of 79 patients meeting inclusion criteria, there were 21.52% distant metastases documented. Time to disease progression of anastrozole, letrozole, and exemestane was 49 months, 58 months, and 53 months, respectively. Letrozole was found better than anastrozole (hazard ratio (HR)=4.342, 95% CI 0.95-19.95; p=0.038). Letrozole versus exemestane (HR=2.757, 95% CI 0.53-14.33; p=0,206) and anastrozole versus exemestane (HR=1.652, 95% CI 0.56-4.84; p=0.351) were found not significantly different. 5-y DFS rate of letrozole was better found (87.5%) than exemestane (73.7%) and anastrozole (61.4%). Conclusion: 5-year letrozole administration could be proposed as first-line therapy for postmenopausal women with HR-positive HER2-negative BC. A considerable subject and long-term follow-up are needed for validation.Copyright © 2023 Tehran University of Medical Sciences.