Department of Breast Surgery, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, PR China.
BMC Cancer. 2010 Jun 11;10:281. doi: 10.1186/1471-2407-10-281.
The rates of chemotherapy-induced amenorrhea (CIA) associated with docetaxel-based regimens reported by previous studies are discordant. For navelbine-based chemotherapies, rates of CIA have seldom been reported.
Of 170 premenopausal patients recruited between January 2003 and September 2008, 78 were treated with fluorouracil plus epirubicin and cyclophosphamide (FEC), 66 were treated with docetaxel plus epirubicin (TE), and 26 were treated with navelbine plus epirubicin (NE). Patient follow-up was carried up every 3-4 months during the first year, then every 9-12 months during subsequent years.
In univariate analysis, the rates of CIA were 44.87% for the FEC regimen, 30.30% for the TE regimen and 23.08% for the NE regimen (P = 0.068). Significant differences in the rates of CIA were not found between the FEC and TE treatment groups (P > 0.05), but were found between the FEC and NE treatment groups (P < 0.05). Furthermore, no significant differences were found between the TE and NE regimens (P > 0.05). Tamoxifen use was a significant predictor for CIA (P = 0.001), and age was also a significant predictor (P < 0.001). In multivariate analysis, age (P < 0.001), the type of chemotherapy regimens (P = 0.009) and tamoxifen use (P = 0.003) were all significant predictors.
Age and administration of tamoxifen were found to be significant predictive factors of CIA, whereas docetaxel and navelbine based regimens were not associated with higher rates of CIA than epirubicin-based regimen.
之前的研究报告显示,依托泊苷方案化疗相关闭经(CIA)的发生率存在差异。对于长春瑞滨为基础的化疗,CIA 的发生率很少有报道。
2003 年 1 月至 2008 年 9 月期间共招募了 170 例绝经前患者,其中 78 例接受氟尿嘧啶+表柔比星+环磷酰胺(FEC)治疗,66 例接受多西紫杉醇+表柔比星(TE)治疗,26 例接受长春瑞滨+表柔比星(NE)治疗。患者随访时间为第一年每 3-4 个月一次,随后每年 9-12 个月一次。
单因素分析显示,FEC 方案的 CIA 发生率为 44.87%,TE 方案为 30.30%,NE 方案为 23.08%(P=0.068)。FEC 和 TE 治疗组之间 CIA 发生率无显著差异(P>0.05),但 FEC 和 NE 治疗组之间差异有统计学意义(P<0.05)。此外,TE 和 NE 方案之间无显著差异(P>0.05)。他莫昔芬的使用是 CIA 的显著预测因素(P=0.001),年龄也是一个显著的预测因素(P<0.001)。多因素分析显示,年龄(P<0.001)、化疗方案类型(P=0.009)和他莫昔芬的使用(P=0.003)均为 CIA 的显著预测因素。
年龄和他莫昔芬的使用是 CIA 的显著预测因素,而依托泊苷和长春瑞滨为基础的方案与表柔比星为基础的方案相比,并不与更高的 CIA 发生率相关。