辅助化疗期间体重增加对乳腺癌患者生存的影响。
The impact of weight gain during adjuvant chemotherapy on survival in breast cancer.
作者信息
Atalay Can, Küçük Ali İmran
机构信息
Clinic of General Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
Clinic of General Surgery, Derince Training and Research Hospital, Kocaeli, Turkey.
出版信息
Ulus Cerrahi Derg. 2015 Sep 1;31(3):124-7. doi: 10.5152/UCD.2015.3123. eCollection 2015.
OBJECTIVE
Weight gain can be detected during adjuvant chemotherapy in breast cancer patients, leading to administration of lower drug doses than planned and a decrease in long-term survival. In this study, the effect of weight gain on survival in breast cancer patients was investigated.
MATERIAL AND METHODS
Breast cancer patients treated with adjuvant chemotherapy between May 2002 and May 2003 were prospectively included in the study. Patients treated with neoadjuvant chemotherapy or with chemotherapy for metastatic disease were excluded from the study. Data regarding patients' demographic, clinical and pathologic characteristics and chemotherapy protocols were recorded. Patients were grouped as those with weight gain less than or more than 3 kg, and those with a body mass index of less than or more than 30. The impact of weight gain on patients' disease-free and overall survival was investigated. Log-rank test and Cox regression analyses were utilized for survival analyses. P<0.05 value was accepted as statistically significant.
RESULTS
Eighty-eight consecutive female patients with a median age of 46 (29-71) were included in the study. Patients received anthracycline based chemotherapy protocols. Weight gain was detected in 79 patients (89.8%), with more than 3 kg weight gain detected in 38 patients (43.2%). In a median follow-up time of 98 months (62-120), distant metastases were detected in 21 patients (23.9%), and 11 patients (12.5%) died. Mean disease-free survival of patients with a weight gain less than and more than 3 kg during chemotherapy was 89.1±3.9 and 84.7±4.2 months (p=0.007), whereas mean overall survival was 95.6±2.2 and 92.5±2.1 months (p=0.01), respectively. Mean disease-free survival of patients with a body mass index less than and more than 30 was 87.3±2.3 and 85.1±3.6 months (p=0.4), whereas mean overall survival was 94.2±2.3 and 92.1±1.1 months (p=0.35), respectively.
CONCLUSION
Weight gain during adjuvant chemotherapy has a negative effect on both disease-free and overall survival in patients with breast cancer.
目的
乳腺癌患者在辅助化疗期间可能出现体重增加，导致药物剂量低于计划给药量，并降低长期生存率。本研究调查了体重增加对乳腺癌患者生存的影响。
材料与方法
前瞻性纳入2002年5月至2003年5月期间接受辅助化疗的乳腺癌患者。接受新辅助化疗或转移性疾病化疗的患者被排除在研究之外。记录患者的人口统计学、临床和病理特征以及化疗方案的数据。患者按体重增加少于或多于3 kg以及体重指数小于或大于30进行分组。研究体重增加对患者无病生存期和总生存期的影响。生存分析采用对数秩检验和Cox回归分析。P<0.05被认为具有统计学意义。
结果
88例连续的女性患者纳入研究，中位年龄为46岁（29 - 71岁）。患者接受基于蒽环类药物的化疗方案。79例患者（89.8%）出现体重增加，38例患者（43.2%）体重增加超过3 kg。在中位随访时间98个月（62 - 120个月）内，21例患者（23.9%）出现远处转移，11例患者（12.5%）死亡。化疗期间体重增加少于3 kg和多于3 kg的患者，平均无病生存期分别为89.1±3.9个月和84.7±4.2个月（p = 0.007），而平均总生存期分别为95.6±2.2个月和92.5±2.1个月（p = 0.01）。体重指数小于30和大于30的患者，平均无病生存期分别为87.3±2.3个月和85.1±3.6个月（p = 0.4），而平均总生存期分别为94.2±2.3个月和92.1±1.1个月（p = 0.35）。
结论
辅助化疗期间体重增加对乳腺癌患者的无病生存期和总生存期均有负面影响。
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