Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Breast Cancer Res Treat. 2013 Jul;140(1):159-76. doi: 10.1007/s10549-013-2594-y.
Maintaining weight is important for better prognosis of breast cancer survivors. The associations between weight and cancer-related symptoms are not known. We examined associations among weight, weight change, inflammation, cancer-related symptoms, and health-related quality of life (HRQOL) in a cohort of stage 0-IIIA breast cancer survivors. Participants were recruited on average 6 months (2–12 months) after diagnosis. Height, weight, and C-reactive protein (CRP) were assessed at approximately 30 months post-diagnosis; cancer-related symptoms (chest wall and arm symptoms, vasomotor symptoms, urinary incontinence, vaginal symptoms, cognition/mood problems, sleep, sexual interest/function), and HRQOL (SF-36) were assessed at approximately 40 months post-diagnosis. Weight was measured at baseline in a subset. Data on 661 participants were evaluable for body mass index (BMI); 483 were evaluable for weight change. We assessed associations between BMI (<25.0, 25.0–29.9, ≥30.0 kg/m2), post-diagnosis weight change (lost ≥5 %, weight change <5 %, gained ≥5 %), and CRP (tertile) with cancer-related symptoms and HRQOL using analysis of covariance. Higher symptoms scores indicate more frequent or severe symptoms. Higher HRQOL scores indicate better HRQOL. Compared with those with BMI <25 kg/m2, women with BMI ≥30 kg/m2 had the following scores: increased for arm symptoms (+25.0 %), urinary incontinence (+40.0 %), tendency to nap (+18.9 %), and poorer physical functioning (−15.6 %, all p < 0.05). Obese women had lower scores in trouble falling asleep (−9.9 %; p < 0.05). Compared with weight change <5 %, participants with ≥5 % weight gain had lower scores in physical functioning (−7.2 %), role-physical (−15.5 %) and vitality (−11.2 %), and those with weight loss ≥5 % had lower chest wall (−33.0 %) and arm symptom scores (−35.5 %, all p < 0.05). Increasing CRP tertile was associated with worse scores for chest wall symptoms, urinary incontinence, physical functioning, role-physical, vitality and physical component summary scores (all P trend < 0.05). Future studies should examine whether interventions to maintain a healthy weight and reduce inflammation could alleviate cancer-related symptoms and improve HRQOL.
维持体重对于乳腺癌幸存者的预后很重要。体重与癌症相关症状之间的关系尚不清楚。我们在一组 0 期至 IIIA 期乳腺癌幸存者中研究了体重、体重变化、炎症、癌症相关症状和健康相关生活质量（HRQOL）之间的关系。参与者在诊断后平均 6 个月（2-12 个月）招募。在诊断后约 30 个月评估身高、体重和 C 反应蛋白（CRP）；在诊断后约 40 个月评估癌症相关症状（胸壁和手臂症状、血管舒缩症状、尿失禁、阴道症状、认知/情绪问题、睡眠、性兴趣/功能）和 HRQOL（SF-36）。体重在基线时在亚组中进行了测量。可评估 661 名参与者的体重指数（BMI）数据；483 名参与者的体重变化可评估。我们使用协方差分析评估 BMI（<25.0、25.0-29.9、≥30.0 kg/m2）、诊断后体重变化（体重减轻≥5%、体重变化<5%、体重增加≥5%）和 CRP（三分位）与癌症相关症状和 HRQOL 的关系。较高的症状评分表示更频繁或更严重的症状。较高的 HRQOL 评分表示更好的 HRQOL。与 BMI<25 kg/m2 的女性相比，BMI≥30 kg/m2 的女性手臂症状（增加 25.0%）、尿失禁（增加 40.0%）、打盹倾向（增加 18.9%）和体力功能（降低 15.6%）得分更高（所有 p<0.05）。肥胖女性入睡困难得分较低（降低 9.9%；p<0.05）。与体重减轻≥5%相比，体重增加≥5%的参与者的身体功能（降低 7.2%）、角色身体（降低 15.5%）和活力（降低 11.2%）评分较低，体重减轻≥5%的参与者的胸壁（降低 33.0%）和手臂症状评分（降低 35.5%）较低（所有 p<0.05）。CRP 三分位增加与胸壁症状、尿失禁、身体功能、角色身体、活力和身体成分综合评分的评分恶化相关（所有 P 趋势<0.05）。未来的研究应该研究维持健康体重和减轻炎症是否可以减轻癌症相关症状并提高 HRQOL。
