Department of Medical Oncology, Prince of Wales Hospital, High Street, Randwick, New South Wales 2031, Australia.
Oncologist. 2011;16(9):1333-44. doi: 10.1634/theoncologist.2011-0100. Epub 2011 Aug 11.
We recently reported that cancer-related fatigue (CRF) after adjuvant breast cancer therapy was prevalent and disabling, but largely self-limiting within 12 months. The current paper describes sexual functioning (SF) and its relationship to CRF, mood disorder, and quality of life (QOL) over the first year after completion of adjuvant therapy.
Women were recruited after surgery, but prior to commencing adjuvant treatment, for early-stage breast cancer. Self-reported validated questionnaires assessed SF, CRF, mood, menopausal symptoms, disability, and QOL at baseline, completion of therapy, and at 6 months and 12 months after treatment.
Of the 218 participants, 92 (42%) completed the SF measure (mean age, 50 years). They were significantly younger, more likely to be partnered, and less likely to be postmenopausal than nonresponders. At baseline, 40% reported problems with sexual interest and 60% reported problems with physical sexual function. SF scores declined across all domains at the end of treatment, then improved but remained below baseline at 12 months, with a significant temporal effect in the physical SF subscale and a trend for overall satisfaction. There were significant correlations between the SF and QOL domains (physical and emotional health, social functioning, and general health) as well as overall QOL. The presence of mood disorder, but not fatigue, demographic, or treatment variables, independently predicted worse overall sexual satisfaction.
Sexual dysfunction is common after breast cancer therapy and impacts QOL. Interventions should include identification and treatment of concomitant mood disorder.
我们最近报告称，辅助乳腺癌治疗后的癌症相关疲劳（CRF）普遍存在且具有致残性，但在 12 个月内基本可自行缓解。本文描述了辅助治疗完成后第一年的性功能（SF）及其与 CRF、情绪障碍和生活质量（QOL）的关系。
招募的女性为早期乳腺癌患者，在手术之后、开始辅助治疗之前。自我报告的经过验证的问卷评估了 SF、CRF、情绪、绝经症状、残疾和 QOL，分别在基线、治疗完成时以及治疗后 6 个月和 12 个月时进行评估。
在 218 名参与者中，92 名（42%）完成了 SF 测量（平均年龄 50 岁）。与未应答者相比，他们更年轻、更有可能有伴侣，绝经的可能性更小。基线时，40%报告存在性兴趣问题，60%报告存在身体性功能问题。SF 评分在治疗结束时所有领域均下降，然后改善，但在 12 个月时仍低于基线，身体 SF 子量表有显著的时间效应，整体满意度呈趋势。SF 与 QOL 领域（身体和情感健康、社会功能和一般健康）以及整体 QOL 之间存在显著相关性。情绪障碍的存在，而不是疲劳、人口统计学或治疗变量，独立预测了整体性满意度较差。
乳腺癌治疗后性功能障碍很常见，会影响 QOL。干预措施应包括识别和治疗并存的情绪障碍。
