Karamitsos A, Kokkas V, Goulas A, Paraskevopoulos P, Gougoulias K, Karampatakis V, Boboridis K
1 University Ophthalmology Department, AHEPA Hospital, Aristotle University of Thessaloniki.
Pharmacology Department, Medical School, Aristotle University of Thessaloniki.
Hippokratia. 2013 Apr;17(2):120-5.
To study possible ocular surface and lacrimal drainage changes in women being on adjuvant chemotherapy with 5-Fluorouracil 600 mg/m2, Epirubicin 60-90 mg/m(2), Cyclophosphamide 600 mg/m(2) (FEC) regimen for breast cancer.
Sixty one consecutive women with early stage breast cancer (median age 58 years - interquartile range 22) were included in this study. They all underwent mastectomy followed by 6 cycles of tri-weekly administration of FEC regimen and were free of ocular surface, eyelid and tear film symptomatic disease at baseline. None of them had pre- or coexisting treatment with other chemotherapeutic agent or radiotherapy. Slit lamp examination of the ocular surface, Schirmer test I (without topical anesthesia) and tears Break up Time test (BUT) were performed before the initiation of treatment and immediately after the third therapeutic cycle.
From 61 women 39.34% had significant conjunctival hyperemia, 41.0% lid margin abnormalities, 4.92% blepharitis, 6.56% madarosis, 3.28% punctate epithelial keratopathy and 4.92% oedema of the lower punctum mucosal opening after three chemotherapeutic cycles. Mean BUT measures were found lower after the third chemotherapeutic cycle (p=0.001) but mean Schirmer test I values were higher after the third chemotherapeutic cycle (p=0.001).
Women on chemotherapy with FEC regimen are more susceptible to develop ocular surface and tear film alterations, within the first three cycles of chemotherapy for breast cancer, and thus, prompt ophthalmological evaluation may be proven beneficial for early diagnosis and management of the induced ocular disease.
研究接受氟尿嘧啶600mg/m²、表柔比星60 - 90mg/m²、环磷酰胺600mg/m²（FEC）方案辅助化疗的乳腺癌女性患者可能出现的眼表和泪道引流变化。
本研究纳入61例连续的早期乳腺癌女性患者（中位年龄58岁 - 四分位间距22岁）。她们均接受了乳房切除术，随后每三周进行6个周期的FEC方案化疗，且基线时无眼表、眼睑和泪膜症状性疾病。她们均未接受过其他化疗药物或放疗的预处理或同期治疗。在治疗开始前和第三个治疗周期后立即进行眼表裂隙灯检查、Schirmer I试验（无表面麻醉）和泪膜破裂时间试验（BUT）。
61例女性患者中，39.34%出现明显结膜充血，41.0%出现睑缘异常，4.92%出现睑缘炎，6.56%出现睫毛脱落，3.28%出现点状上皮性角膜炎，4.92%出现下泪点黏膜开口水肿。第三个化疗周期后BUT平均测量值降低（p = 0.001），但第三个化疗周期后Schirmer I试验平均测量值升高（p = 0.001）。
接受FEC方案化疗的乳腺癌女性患者在化疗的前三个周期内更容易出现眼表和泪膜改变，因此，及时的眼科评估可能有助于早期诊断和治疗所诱发的眼部疾病。
