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比较每 3 个月注射一次醋酸亮丙瑞林 2 年与 3 年以上联合他莫昔芬作为辅助内分泌治疗用于绝经前内分泌受体阳性乳腺癌患者的生活质量:一项随机对照试验。

Comparison of quality of life between 2-year and 3-or-more-year administration of leuprorelin acetate every-3-months depot in combination with tamoxifen as adjuvant endocrine treatment in premenopausal patients with endocrine-responsive breast cancer: a randomized controlled trial.

机构信息

Department of Integrated Science and Engineering for Sustainable Society, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo, 112-8551, Japan.

Department of Breast Surgery, Osaka Breast Clinic, Osaka, Japan.

出版信息

Support Care Cancer. 2018 Mar;26(3):933-945. doi: 10.1007/s00520-017-3914-2. Epub 2017 Oct 24.

Abstract

BACKGROUND

We conducted an open-label, randomized controlled trial evaluating the appropriate treatment duration of leuprorelin acetate 3-month depot, TAP-144-SR (3M), administered postsurgically every 3 months for 2 years versus 3 or more (up to 5) years, in combination with tamoxifen, for 5 years in premenopausal endocrine-responsive breast cancer patients and reported similar survival benefit in the two treatment groups. We hereby present patient-reported quality of life (QOL) data obtained from this trial.

METHODS

Three self-administered QOL questionnaires (QOL-ACD, QOL-ACD-B, FACT-ES subscale) were used, and the difference in QOL score changes between the two groups was analyzed using a mixed-effects model for repeated measures.

RESULTS

Eligible patients (N = 222) were randomly assigned to a 2-year (2YG, N = 112) or 3-or-more-year treatment group (3YG, N = 110). The time courses of the three QOL scores during the trial period were similar in the two groups. The mean changes in the QOL scores from week 96 were largely stable through week 240 in the 3YG, but showed significantly greater improvement in the score changes from week 96 in the 2YG than the 3YG. Symptoms associated with menopause such as hot flashes and sweating contributed to these results. Menstruation recovery was associated with significantly greater improvement of these symptoms in the 2YG than the 3YG.

CONCLUSIONS

Patient-reported menopause-associated symptoms and QOL improved after discontinuation of the LH-RH agonist administration and menstruation recovery. QOL information should be a consideration in long-term treatment.

摘要

背景

我们进行了一项开放标签、随机对照试验,评估了醋酸亮丙瑞林 3 个月缓释剂(TAP-144-SR,3M)术后每 3 个月给药 1 次、持续 2 年,与他莫昔芬联合使用 5 年,用于绝经前内分泌敏感型乳腺癌患者,结果显示两组患者的生存获益相似。现将该试验获得的患者报告的生活质量(QOL)数据报告如下。

方法

使用了 3 种自我管理的 QOL 问卷(QOL-ACD、QOL-ACD-B、FACT-ES 亚量表),采用重复测量混合效应模型分析两组间 QOL 评分变化的差异。

结果

符合条件的患者(N=222)被随机分配至 2 年治疗组(2YG,N=112)或 3 年以上治疗组(3YG,N=110)。两组在试验期间的三个 QOL 评分时间过程相似。3YG 从第 96 周开始的 QOL 评分变化基本稳定,持续至第 240 周,但 2YG 第 96 周开始的评分变化明显优于 3YG。与绝经相关的症状,如热潮红和出汗,导致了这些结果。月经恢复与这些症状的显著改善有关,在 2YG 比 3YG 更为明显。

结论

停用 LH-RH 激动剂和月经恢复后,患者报告的与绝经相关的症状和 QOL 得到改善。QOL 信息应作为长期治疗的考虑因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f3c/5785605/bb053935aac5/520_2017_3914_Fig1_HTML.jpg

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