Fallowfield Lesley, McGurk Rhona, Dixon Michael
Cancer Research UK Psychosocial Oncology Group, Brighton & Sussex Medical School, University of Sussex, Falmer BN1 9QG, UK.
Eur J Cancer. 2004 Nov;40(16):2403-10. doi: 10.1016/j.ejca.2004.07.013.
The aim of this study was to determine the treatment preferences (adjuvant goserelin or cyclophosphamide, methotrexate and fluorouracil (CMF) chemotherapy) of healthy premenopausal women should they hypothetically develop oestrogen-receptor (ER) positive early breast cancer. Two hundred pre or peri-menopausal women read two scenarios describing goserelin or chemotherapy. Information included: How and where treatments were administered, side-effects, their likely persistence and impact on fertility. Women stated their unprompted initial and final preferences with reasons for the choices made. Respondents showed an overwhelming preference for goserelin. 156 (78%) women favoured goserelin, 22 (11%) chemotherapy and 22 (11%) remained undecided (P<0.0001). Primary reasons for preferring goserelin for were 105 (71%) avoidance of chemotherapy side-effects, especially hair loss, perceived convenience and less disruption to normal life 54 (36%). The minority who preferred chemotherapy, valued the treatment finishing more quickly. These results together with clinical trial data showing equivalence of goserelin with CMF regimens suggest that premenopausal women with ER-positive tumours should at least be offered the choice of either adjuvant hormone therapy or chemotherapy.
本研究的目的是确定健康的绝经前女性如果假设发生雌激素受体（ER）阳性早期乳腺癌时的治疗偏好（辅助性戈舍瑞林或环磷酰胺、甲氨蝶呤和氟尿嘧啶（CMF）化疗）。两百名绝经前或围绝经期女性阅读了描述戈舍瑞林或化疗的两种情景。信息包括：治疗的给药方式和地点、副作用、其可能的持续时间以及对生育能力的影响。女性陈述了她们未经提示的初始和最终偏好以及做出选择的理由。受访者对戈舍瑞林表现出压倒性的偏好。156名（78%）女性倾向于戈舍瑞林，22名（11%）倾向于化疗，22名（11%）仍未决定（P<0.0001）。倾向于戈舍瑞林的主要原因是105名（71%）避免化疗副作用，尤其是脱发，54名（36%）认为方便且对正常生活干扰较小。少数倾向于化疗的人看重治疗结束得更快。这些结果连同显示戈舍瑞林与CMF方案等效的临床试验数据表明，患有ER阳性肿瘤的绝经前女性至少应被提供辅助激素治疗或化疗的选择。
