Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, Japan.
Breast Cancer. 2011 Jul;18(3):182-8. doi: 10.1007/s12282-011-0256-7. Epub 2011 Mar 11.
The purpose of this study was to determine the incidence of amenorrhea among breast cancer patients aged 40 years and younger following adjuvant chemotherapy.
A follow-up questionnaire survey was conducted with premenopausal women with breast cancer who were treated with adjuvant anthracycline and taxane-based chemotherapy.
In total, 66 women were retrospectively reviewed. Forty-nine patients were treated with a regimen containing anthracycline followed by taxane and 17 patients with anthracycline alone. Fifty-eight patients (87.9%) experienced amenorrhea during chemotherapy; 14 patients (21.2%) had persistent amenorrhea after chemotherapy. The incidence of amenorrhea during chemotherapy and persistent amenorrhea was higher in patients older than 36 than in younger patients (97.9 vs. 63.2%, 27.7 vs. 5.3%). Additional taxane resulted in a higher incidence of amenorrhea compared with anthracycline-containing regimen alone (93.9 vs. 70.6%). Multivariate analysis showed that age (≥36 years) was independently associated with the incidences of amenorrhea during chemotherapy (p = 0.007).
Age was the strongest predictor of the incidence of amenorrhea during chemotherapy. It is unclear whether additional taxane may contribute to amenorrhea. This information could be useful in deciding whether to use adjuvant chemotherapy.
本研究旨在确定接受蒽环类和紫杉类辅助化疗的 40 岁以下乳腺癌患者发生闭经的发生率。
对接受蒽环类和紫杉类辅助化疗的绝经前乳腺癌女性进行了随访问卷调查。
共回顾性分析了 66 例患者。49 例患者接受蒽环类序贯紫杉类方案治疗,17 例患者仅接受蒽环类方案治疗。58 例(87.9%)患者在化疗期间出现闭经;14 例(21.2%)患者在化疗后仍持续闭经。年龄大于 36 岁的患者化疗期间和化疗后闭经的发生率高于年龄小于 36 岁的患者(97.9%比 63.2%,27.7%比 5.3%)。与蒽环类药物序贯紫杉类方案相比,单纯蒽环类药物方案加用紫杉类药物导致闭经的发生率更高(93.9%比 70.6%)。多因素分析显示,年龄(≥36 岁)是化疗期间闭经发生率的独立相关因素(p=0.007)。
年龄是化疗期间闭经发生率的最强预测因素。尚不清楚是否额外使用紫杉类药物会导致闭经。这些信息可能有助于决定是否使用辅助化疗。