Bender Catherine M, Sereika Susan M, Brufsky Adam M, Ryan Christopher M, Vogel Victor G, Rastogi Priya, Cohen Susan M, Casillo Frances E, Berga Sarah L
University of Pittsburgh School of Nursing, Pittsburgh, PA 15261, USA.
Menopause. 2007 Nov-Dec;14(6):995-8. doi: 10.1097/gme.0b013e318148b28b.
Hormones have been implicated as modulators of cognitive functioning. For instance, results of our previous work in women with breast cancer showed that cognitive impairment was more severe and involved more memory domains in those who received adjuvant tamoxifen therapy compared with women who received chemotherapy alone or no adjuvant therapy. Recently aromatase inhibitors such as anastrozole have been used in lieu of tamoxifen for the adjuvant treatment of postmenopausal women with hormone receptor-positive, early-stage breast cancer. Plasma estrogen levels are significantly lower in women who receive anastrozole compared with those who receive tamoxifen. We hypothesized, therefore, that anastrozole would have a more profound effect on cognitive function than tamoxifen, a mixed estrogen agonist/antagonist.
To test this hypothesis we compared cognitive function in women with early-stage breast cancer who received tamoxifen with those who received anastrozole therapy in a cross-sectional study. We evaluated cognitive function, depression, anxiety, and fatigue in 31 postmenopausal women with early-stage breast cancer who were between the ages of 21 and 65 years and treated with tamoxifen or anastrozole for a minimum of 3 months.
The results showed that women who received anastrozole had poorer verbal and visual learning and memory than women who received tamoxifen.
Additional, prospective studies are needed to validate and confirm the changes in cognitive function associated with hormone therapy for breast cancer.
激素被认为是认知功能的调节因子。例如，我们之前对乳腺癌女性的研究结果表明，与单纯接受化疗或未接受辅助治疗的女性相比，接受辅助他莫昔芬治疗的女性认知障碍更严重，涉及更多记忆领域。最近，阿那曲唑等芳香化酶抑制剂已被用于替代他莫昔芬，用于辅助治疗激素受体阳性的绝经后早期乳腺癌女性。与接受他莫昔芬治疗的女性相比，接受阿那曲唑治疗的女性血浆雌激素水平显著更低。因此，我们推测，与混合性雌激素激动剂/拮抗剂他莫昔芬相比，阿那曲唑对认知功能的影响会更深远。
为了验证这一假设，我们在一项横断面研究中比较了接受他莫昔芬治疗和接受阿那曲唑治疗的早期乳腺癌女性的认知功能。我们评估了31名年龄在21至65岁之间、接受他莫昔芬或阿那曲唑治疗至少3个月的绝经后早期乳腺癌女性的认知功能、抑郁、焦虑和疲劳情况。
结果显示，接受阿那曲唑治疗的女性在言语和视觉学习及记忆方面比接受他莫昔芬治疗的女性更差。
需要更多前瞻性研究来验证和确认与乳腺癌激素治疗相关的认知功能变化。
