Department of Obstetrics and Gynecology, University Hospitals Leuven and Katholieke Universiteit Leuven, Belgium.
Ann Oncol. 2012 Jun;23(6):1449-54. doi: 10.1093/annonc/mdr478. Epub 2011 Oct 29.
We studied the stellate ganglion block (SGB) recently suggested for the treatment of severe vasomotor symptoms and sleep disturbances in breast cancer survivors. Following an initial pilot study, which focused on the acceptability and safety of SGB for this important problem, we evaluated its short- and long-term efficacy.
Postmenopausal breast cancer survivors with severe vasomotor symptoms resistant to standard nonhormonal pharmacological intervention were eligible. Diaries were used to measure daily hot flash scores (frequency and intensity) and sleep quality (Pittsburgh Sleep Quality Index) during scheduled visits at baseline, 1, 4, 12 and 24 weeks following the SGB. Efficacy data were analyzed using longitudinal regression models.
Thirty-four patients participated and none refused the SGB procedure. Most patients received more than one SGB. The pilot study found SGB to be safe. In the main study, hot flash scores were reduced from baseline by 64% [95% confidence interval (CI) -74% to -49%] and 47% (95% CI -62% to -27%) at weeks 1 and 24, respectively. The odds ratio of better sleep quality relative to baseline was 3.4 at week 1 (95% CI 1.6-7.2) and 4.3 at week 24 (95% CI 1.9-9.8).
In the short term, SGB appears to be an effective treatment with acceptable morbidity for some breast cancer survivors with therapy-resistant vasomotor symptoms and/or sleep disturbances. Although sleep quality was maintained out to 24 weeks the efficacy of SGB for hot flashes was reduced over time. A randomized controlled trial is needed to confirm these findings.
我们最近研究了星状神经节阻滞（SGB），用于治疗乳腺癌幸存者的严重血管舒缩症状和睡眠障碍。在一项初步的试点研究之后，我们评估了 SGB 的短期和长期疗效，该研究侧重于 SGB 治疗这一重要问题的可接受性和安全性。
患有严重血管舒缩症状且对标准非激素药物干预无反应的绝经后乳腺癌幸存者符合条件。在基线、SGB 后 1、4、12 和 24 周的预约就诊时，使用日记来测量每日潮热评分（频率和强度）和睡眠质量（匹兹堡睡眠质量指数）。使用纵向回归模型分析疗效数据。
34 名患者参与，无人拒绝 SGB 程序。大多数患者接受了不止一次 SGB。试点研究发现 SGB 是安全的。在主要研究中，潮热评分从基线降低了 64%[95%置信区间（CI）-74%至-49%]和 47%（95% CI -62%至-27%）分别在第 1 周和第 24 周。与基线相比，睡眠质量更好的几率在第 1 周为 3.4（95% CI 1.6-7.2），在第 24 周为 4.3（95% CI 1.9-9.8）。
短期来看，SGB 似乎是一种有效的治疗方法，对于一些有治疗抵抗性血管舒缩症状和/或睡眠障碍的乳腺癌幸存者，其发病率可以接受。尽管 SGB 对潮热的疗效随着时间的推移而降低，但睡眠质量可维持到 24 周。需要进行随机对照试验来证实这些发现。
