Makari-Judson Grace, Judson Christopher H, Mertens Wilson C
Comprehensive Breast Center and Baystate Regional Cancer Program, Springfield, Massachusetts 01107, USA.
Breast J. 2007 May-Jun;13(3):258-65. doi: 10.1111/j.1524-4741.2007.00419.x.
Many, but not all patients experience weight gain 1 year after a breast cancer diagnosis; clearly defined, clinically relevant groups at risk of weight gain have yet to be described. We set out to determine the factors associated with weight gain over time in patients with invasive breast cancer during a period of predominantly anthracycline-based adjuvant chemotherapy and to identify groups with differing weight gain risks. Breast cancer patients (stage I-IIIB) were identified in a retrospective chart review. Evaluated parameters included weight at diagnosis and 1, 2, and 3 years later, height, body mass index (BMI), age, menopausal and change in menopausal status, as well as therapy and pathologic stage. Regression models identified significant independent predictors of weight change. Recursive partitioning analysis (RPA) was employed to divide the dataset into relevant and significant groups. In 185 identified patients, regression models and RPA demonstrated that weight gain at 1 year was associated with younger age, adjuvant chemotherapy, and lower BMI. Weight gain at 2 years (n = 176) was greater than at year 1, and in addition to weight gain at year 1, was associated with younger age and adjuvant chemotherapy in regression analysis; RPA found that anthracycline therapy, age, and BMI were important. Weights at 3 years were similar to those seen at 2 years. Early-stage breast cancer patients treated with chemotherapy continue to gain weight 2 years after diagnosis, and this weight gain appears to be persistent at year 3. Observation beyond 1 year is needed to adequately evaluate weight gain in early-stage breast cancer patients, particularly for those receiving contemporary adjuvant chemotherapy.
许多(但并非所有)乳腺癌患者在确诊后1年会出现体重增加;尚未明确界定有体重增加风险的临床相关群体。我们旨在确定浸润性乳腺癌患者在以蒽环类药物为主的辅助化疗期间体重随时间增加的相关因素,并识别体重增加风险不同的群体。通过回顾性病历审查确定了乳腺癌患者(I-IIIB期)。评估参数包括确诊时、1年、2年和3年后的体重、身高、体重指数(BMI)、年龄、绝经及绝经状态变化,以及治疗和病理分期。回归模型确定了体重变化的显著独立预测因素。采用递归划分分析(RPA)将数据集分为相关且有意义的组。在185名确诊患者中,回归模型和RPA表明,1年时体重增加与年龄较小、辅助化疗和较低的BMI有关。2年时(n = 176)体重增加大于1年时,在回归分析中,除了1年时体重增加外,还与年龄较小和辅助化疗有关;RPA发现蒽环类药物治疗、年龄和BMI很重要。3年时的体重与2年时相似。接受化疗的早期乳腺癌患者在确诊后2年体重持续增加,且这种体重增加在第3年似乎持续存在。需要超过1年的观察来充分评估早期乳腺癌患者的体重增加情况,特别是对于那些接受当代辅助化疗的患者。