Okishiro Masatsugu, Taguchi Tetsuya, Kim Seung Jin, Tanji Yoshio, Shimazu Kenzo, Tamaki Yasuhiro, Noguchi Shinzaburo
Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, 2-2-E10 Yamadaoka, Suita, Osaka 565-0871, Japan.
J Cancer Res Clin Oncol. 2009 Jun;135(6):823-7. doi: 10.1007/s00432-008-0518-8. Epub 2008 Nov 26.
Incidence of joint symptoms and bone fractures as well as changes in bone mineral density (BMD) in Japanese postmenopausal breast cancer patients treated with adjuvant anastrozole were investigated to determine whether there is an ethnic difference from Caucasian patients in the incidence of these adverse events of anastrozole.
Adjuvant anastrozole was used to treat 348 postmenopausal breast cancer patients for a median period of 22 months. Adverse events of anastrozole including joint symptoms, loss of BMD, and bone fracture were investigated by means of chart review.
Joint symptoms developed in 96 (27.5%) patients. Age (younger than 65) and prior chemotherapy was strongly associated with an increased risk of joint symptoms. Annual fracture incidence was 0.86 and 0.85% and lumbar BMD decreased by 1.3 and 2.8% at 1 and 2 years, respectively. In comparison, the ATAC trial reported corresponding figures of 2.0 and 2.7 and of 2.2 and 4.0%.
Incidence and risk factors of joint symptoms are similar for Japanese and Caucasian patients, but the former tend to show a smaller decrease in BMD and a lower incidence of bone fractures, probably due to ethnic difference in the hormonal milieu.
研究接受辅助性阿那曲唑治疗的日本绝经后乳腺癌患者的关节症状和骨折发生率以及骨矿物质密度(BMD)的变化,以确定这些阿那曲唑不良事件的发生率与白种人患者是否存在种族差异。
使用辅助性阿那曲唑治疗348例绝经后乳腺癌患者,中位治疗时间为22个月。通过病历审查调查阿那曲唑的不良事件,包括关节症状、BMD降低和骨折。
96例(27.5%)患者出现关节症状。年龄(小于65岁)和既往化疗与关节症状风险增加密切相关。年骨折发生率分别为0.86%和0.85%,1年和2年时腰椎BMD分别下降1.3%和2.8%。相比之下,ATAC试验报告的相应数字分别为2.0%和2.7%,以及2.2%和4.0%。
日本和白种人患者关节症状的发生率和危险因素相似,但前者的BMD下降幅度较小,骨折发生率较低,这可能是由于激素环境的种族差异所致。