Yap Karen P L, McCready David R, Fyles Anthony, Manchul Lee, Trudeau Maureen, Narod Steven
Department of Surgical Oncology, Princess Margaret Hospital, 610 University Ave., Toronto, Ontario M5G 2M9, Canada.
Breast J. 2004 Nov-Dec;10(6):481-6. doi: 10.1111/j.1075-122X.2004.21497.x.
The goal of this study was to determine the frequency of alternative therapy use in postmenopausal women with early stage breast cancer who were enrolled in a randomized clinical trial designed to determine the value of breast irradiation after treatment with breast-conserving surgery and tamoxifen. A questionnaire was given to 300 patients, ages 52 to 90 years, after completion of radiation therapy (if any). Of the 290 respondents, 78 (27%) had used some form of alternative therapy. Of these, 60.3% started after the diagnosis of breast cancer. Users of alternative therapies were significantly younger than nonusers (67.0 +/- 8.4 years versus 70.0 +/- 8.7 years, p = 0.009) and they used a median of one type of therapy per person (range 1-13). Users of alternative therapies were more likely to have experienced symptoms (stiffness, pain, numbness, or swelling) in the ipsilateral shoulder or arm after treatment of their breast cancers compared to nonusers (odds ratio [OR] = 2.0, p = 0.02). This relationship between alternative therapy use and symptoms was strongest in the group who started alternative therapies after breast cancer diagnosis (OR = 2.1, p = 0.05). On multivariate analysis, younger age and radiotherapy treatment were related to alternative therapy use. In conclusion, 27% of patients with early stage breast cancer used alternative therapy. Users were more likely to be younger and to experience shoulder or arm symptoms after breast-conserving surgery with radiation.
本研究的目的是确定参加一项随机临床试验的绝经后早期乳腺癌女性使用替代疗法的频率，该试验旨在确定保乳手术和他莫昔芬治疗后进行乳房照射的价值。在完成放射治疗（如有）后，向300名年龄在52至90岁之间的患者发放了问卷。在290名受访者中，78人（27%）使用了某种形式的替代疗法。其中，60.3%在乳腺癌诊断后开始使用。替代疗法使用者的年龄显著低于非使用者（67.0±8.4岁对70.0±8.7岁，p = 0.009），且每人使用的疗法中位数为一种（范围为1 - 13种）。与非使用者相比，替代疗法使用者在乳腺癌治疗后更有可能在同侧肩部或手臂出现症状（僵硬、疼痛、麻木或肿胀）（比值比[OR]=2.0，p = 0.02）。在乳腺癌诊断后开始使用替代疗法的人群中，替代疗法使用与症状之间的这种关系最为强烈（OR = 2.1，p = 0.05）。多因素分析显示，年龄较小和接受放射治疗与使用替代疗法有关。总之，27%的早期乳腺癌患者使用了替代疗法。使用者更有可能年龄较小，并且在保乳手术加放疗后出现肩部或手臂症状。
