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中国年轻乳腺癌患者辅助化疗后的生活质量

Quality of life of young Chinese breast cancer patients after adjuvant chemotherapy.

作者信息

Yeo Winnie, Mo Frankie Kf, Pang Elizabeth, Suen Joyce Js, Koh Jane, Yip Claudia Hw, Yip Christopher Ch, Li Leung, Loong Herbert Hf, Liem Giok S

机构信息

Department of Clinical Oncology, Sir YK Pao Centre for Cancer, Prince of Wales Hospital.

Hong Kong Cancer Institute, State Key Laboratory of Oncology in South China, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.

出版信息

Cancer Manag Res. 2018 Feb 22;10:383-389. doi: 10.2147/CMAR.S149983. eCollection 2018.

Abstract

INTRODUCTION

Understanding of quality of life (QoL) of young Chinese breast cancer patients after adjuvant cytotoxic chemotherapy is limited. This study aims to assess the QoL of premenopausal Chinese breast cancer women after receiving adjuvant chemotherapy.

PATIENTS AND METHODS

Eligibility criteria included stage I-III breast cancer, premenopausal and age ≤45 years at cancer diagnosis and having received adjuvant chemotherapy within 3-10 years before entry to the present study. Patients' background demographics at the time of breast cancer diagnosis, together with tumor characteristics and anticancer treatments, were collected. At the time of study entry, the menopausal status based on menstrual history, body mass index, and QoL (assessed using Functional Assessment of Cancer Therapy-Breast +4) were recorded.

RESULTS

Two hundred and eighty patients were recruited. Ninety-five patients (33.9%) underwent breast-conserving surgery, and nearly all (98.6%) underwent axillary dissection. For adjuvant therapies, 249 patients (88.9%) received anthracycline-containing chemotherapy and 79 (28.2%) received taxane-containing chemotherapy, while 68 (24.3%) received both. One hundred and eighty six patients (66.4%) received adjuvant radiotherapy, and 214 (76.4%) received adjuvant tamoxifen. The median time from breast cancer diagnosis to study entry was 5.01 years. QoL assessment at study entry revealed that older patients had worse social well-being (SWB; mean scores for age ≤40, 41-45, 46-50 and >50 years were 22.0, 19.3, 19.1 and 18.1, respectively, =0.0442). Patients who underwent axillary dissection had worse scores for breast cancer sub-scale (BCS; mean score 22.2 vs. 28.3, =0.0212). Patients who underwent taxane-containing chemotherapy had worse scores for arm subscale (mean score 13.8 vs. 15.3, =0.0053).

CONCLUSION

At a median follow-up of 5 years post-diagnosis, patients who were younger had fewer disturbances in their SWB. Patients who had axillary dissection had worse BCS scores, while those who received taxane had worse scores for arm subscale. Further studies are warranted for breast-specific QoL to address the specific issues encountered by breast cancer patients.

摘要

引言

对于接受辅助细胞毒性化疗后的中国年轻乳腺癌患者的生活质量(QoL)了解有限。本研究旨在评估绝经前中国乳腺癌女性接受辅助化疗后的生活质量。

患者与方法

纳入标准包括I-III期乳腺癌、绝经前且癌症诊断时年龄≤45岁,并在进入本研究前3至10年内接受过辅助化疗。收集患者乳腺癌诊断时的背景人口统计学信息,以及肿瘤特征和抗癌治疗情况。在研究入组时,记录基于月经史、体重指数的绝经状态以及生活质量(使用癌症治疗功能评估-乳腺+4进行评估)。

结果

招募了280名患者。95名患者(33.9%)接受了保乳手术,几乎所有患者(98.6%)接受了腋窝清扫术。对于辅助治疗,249名患者(88.9%)接受了含蒽环类化疗,79名患者(28.2%)接受了含紫杉烷化疗,68名患者(24.3%)两者均接受。186名患者(66.4%)接受了辅助放疗,214名患者(76.4%)接受了辅助他莫昔芬治疗。从乳腺癌诊断到研究入组的中位时间为5.01年。研究入组时的生活质量评估显示,年龄较大的患者社会幸福感(SWB)较差(年龄≤40岁、41-45岁、46-50岁和>50岁患者的平均得分分别为22.0、19.3、19.1和18.1,P=0.0442)。接受腋窝清扫术的患者乳腺癌子量表(BCS)得分较差(平均得分22.2对28.3,P=0.0212)。接受含紫杉烷化疗的患者手臂子量表得分较差(平均得分13.8对15.3,P=0.0053)。

结论

在诊断后中位随访5年时,年龄较小的患者社会幸福感干扰较少。接受腋窝清扫术的患者BCS得分较差,而接受紫杉烷治疗的患者手臂子量表得分较差。有必要针对乳腺癌特异性生活质量开展进一步研究,以解决乳腺癌患者遇到的具体问题。

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