Tchen Nadine, Juffs Helen G, Downie Fiona P, Yi Qi-Long, Hu Hanxian, Chemerynsky Irene, Clemons Mark, Crump Michael, Goss Paul E, Warr David, Tweedale Mary E, Tannock Ian F
Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada.
J Clin Oncol. 2003 Nov 15;21(22):4175-83. doi: 10.1200/JCO.2003.01.119.
There is evidence that cognitive dysfunction, fatigue, and menopausal symptoms may occur in women receiving adjuvant chemotherapy for breast cancer. Here, we determine their incidence and severity, and interrelationships between them and quality of life.
In this study, 110 women receiving adjuvant chemotherapy each nominated a female relative, friend, or neighbor (matched by age) as a control; 100 eligible matched pairs were evaluated. Patients and controls completed the following assessments: the High-Sensitivity Cognitive Screen, and the Functional Assessment of Cancer Therapy-General (FACT-G) quality of life scale with subscales for fatigue (FACT-F) and endocrine symptoms (FACT-ES). They also performed tests of attention and reaction time.
Patients and controls were well matched for age and level of education. There was a higher incidence of moderate or severe cognitive impairment in the patient group (16% v 4%; P =.008). Patients experienced much more fatigue than controls (median FACT-F scores, 31 v 46; P <.0001) and more menopausal symptoms (median FACT-ES scores, 58 v 64; P <.0001). Self-reported quality of life of the patients was poorer than for controls, especially in physical and functional domains (median FACT-G scores, 77 v 93; P <.0001). There was strong correlation between fatigue, menopausal symptoms, and quality of life (P <.0001 for each pair), but none were significantly associated with the presence of cognitive dysfunction.
Adjuvant chemotherapy causes cognitive dysfunction, fatigue, and menopausal symptoms in women with breast cancer. Priority should be given to the study of strategies that might reduce these toxic effects.
有证据表明，接受乳腺癌辅助化疗的女性可能会出现认知功能障碍、疲劳和更年期症状。在此，我们确定它们的发生率和严重程度，以及它们与生活质量之间的相互关系。
在本研究中，110名接受辅助化疗的女性各自指定一名女性亲属、朋友或邻居（年龄匹配）作为对照；对100对符合条件的匹配对进行了评估。患者和对照完成了以下评估：高敏认知筛查，以及癌症治疗功能评估通用量表（FACT-G），该量表带有疲劳（FACT-F）和内分泌症状（FACT-ES）的子量表。他们还进行了注意力和反应时间测试。
患者和对照在年龄和教育水平方面匹配良好。患者组中中度或重度认知障碍的发生率更高（16%对4%；P = 0.008）。患者比对照经历了更多的疲劳（FACT-F评分中位数，31对46；P < 0.0001）和更多的更年期症状（FACT-ES评分中位数，58对64；P < 0.0001）。患者自我报告的生活质量比对照差，尤其是在身体和功能领域（FACT-G评分中位数，77对93；P < 0.0001）。疲劳、更年期症状和生活质量之间存在很强的相关性（每对P < 0.0001），但均与认知功能障碍的存在无显著关联。
辅助化疗会导致乳腺癌女性出现认知功能障碍、疲劳和更年期症状。应优先研究可能减少这些毒性作用的策略。
