Center for Neuroimaging, Department of Radiology and Imaging Sciences and the Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, 950 W. Walnut St., R2 E124, Indianapolis, IN 46202, USA.
Breast Cancer Res Treat. 2010 Oct;123(3):819-28. doi: 10.1007/s10549-010-1088-4. Epub 2010 Aug 6.
Brain gray matter alterations have been reported in cross-sectional magnetic resonance imaging (MRI) studies of breast cancer patients after cancer treatment. Here we report the first prospective MRI study of women undergoing treatment for breast cancer, with or without chemotherapy, as well as healthy controls. We hypothesized that chemotherapy-associated changes in gray matter density would be detectable 1 month after treatment, with partial recovery 1 year later. Participants included breast cancer patients treated with (CTx+, N = 17) or without (CTx-, N = 12) chemotherapy and matched healthy controls (N = 18). MRI scans were acquired at baseline (after surgery but before radiation, chemotherapy, and/or anti-estrogen treatment), 1 month after completion of chemotherapy (M1), and 1 year later (Y1). Voxel-based morphometry (VBM) was used to evaluate gray matter density differences between groups and over time. There were no between-group gray matter differences at baseline. Group-by-time interactions showed declines from baseline to M1 in both cancer groups relative to controls. Within-group analyses indicated that at M1 relative to baseline the CTx+ group had decreased gray matter density in bilateral frontal, temporal, and cerebellar regions and right thalamus. Recovery was seen at Y1 in some regions, although persistent decreases were also apparent. No significant within-group changes were found in the CTx- or control groups. Findings were not attributable to recency of cancer surgery, disease stage, psychiatric symptoms, psychotropic medication use, or hormonal treatment status. This study is the first to use a prospective, longitudinal approach to document decreased brain gray matter density shortly after breast cancer chemotherapy and its course of recovery over time. These gray matter alterations appear primarily related to the effects of chemotherapy, rather than solely reflecting host factors, the cancer disease process, or effects of other cancer treatments.
脑灰质变化已经在乳腺癌患者癌症治疗后的横断面磁共振成像（MRI）研究中报道过。在这里，我们报告了第一例对接受乳腺癌治疗的女性（包括接受或不接受化疗的患者）以及健康对照者进行前瞻性 MRI 研究。我们假设，化疗相关的灰质密度变化将在治疗后 1 个月检测到，并在 1 年后部分恢复。参与者包括接受化疗（CTx+，N=17）或未接受化疗（CTx-，N=12）治疗的乳腺癌患者以及匹配的健康对照组（N=18）。MRI 扫描在基线（手术完成后但在放疗、化疗和/或抗雌激素治疗之前）、化疗完成后 1 个月（M1）和 1 年后（Y1）采集。基于体素的形态计量学（VBM）用于评估组间和随时间的灰质密度差异。基线时各组间无灰质差异。组间时间交互作用显示，与对照组相比，两组癌症患者的基线到 M1 均有下降。组内分析表明，与基线相比，CTx+组在双侧额、颞和小脑以及右侧丘脑的灰质密度降低。在 Y1 时出现了恢复，但也明显存在持续的减少。在 CTx-或对照组中未发现明显的组内变化。这些发现与癌症手术的近期性、疾病分期、精神症状、精神药物使用或激素治疗状况无关。这项研究首次采用前瞻性、纵向方法记录乳腺癌化疗后不久脑灰质密度降低及其随时间的恢复过程。这些灰质改变似乎主要与化疗的影响有关，而不仅仅反映宿主因素、癌症疾病过程或其他癌症治疗的影响。
