City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, California.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
J Am Geriatr Soc. 2019 May;67(5):920-927. doi: 10.1111/jgs.15493. Epub 2018 Aug 26.
To analyze self-reported changes in physical function in older women with breast cancer receiving adjuvant chemotherapy.
Secondary analysis of the Cancer and Leukemia Group B (CALGB) 49907 prospective randomized clinical trial.
CALGB institutions in the United States.
Women aged 65 and older with Stage I to III breast cancer enrolled in CALGB 49907 who had physical function data from before and after receipt of adjuvant chemotherapy (N=256; mean age 71.5, range 65-85).
Participants were administered the physical function subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire before chemotherapy, at the end of chemotherapy, and 12 months after chemotherapy initiation. Functional decline was defined as a more than 10-point decrease from baseline at each time point. Resilience was defined as return to within 10 points of baseline. Multivariable regression was used to examine pretreatment characteristics associated with physical function changes.
Of 42% of participants who had physical function decline from before to the end of chemotherapy, 47% recovered by 12 months (were resilient). Almost one-third experienced functional decline from before chemotherapy to 12 months later. Pretreatment fatigue was a risk factor for functional decline from before to the end of chemotherapy (P=.02). Risk factors for functional decline at 12 months included pretreatment dyspnea (P=.007) and being unmarried (P=.01).
Functional decline was common in older women receiving adjuvant chemotherapy for breast cancer in a clinical trial. Although half recovered their physical function, one-third had a clinically meaningful decline at 12 months. Strategies are needed to prevent functional decline in older adults receiving chemotherapy. J Am Geriatr Soc 67:920-927, 2019.
分析接受辅助化疗的老年乳腺癌女性自我报告的身体功能变化。
癌症和白血病组 B（CALGB）49907 前瞻性随机临床试验的二次分析。
美国 CALGB 机构。
年龄在 65 岁及以上、患有 I 期至 III 期乳腺癌的女性，参与 CALGB 49907 并在接受辅助化疗前后有身体功能数据（N=256；平均年龄 71.5 岁，范围 65-85 岁）。
参与者在化疗前、化疗结束时和化疗开始后 12 个月接受欧洲癌症研究与治疗组织生活质量问卷的身体功能子量表。功能下降定义为每个时间点与基线相比下降超过 10 分。恢复定义为恢复到与基线相差 10 分以内。多变量回归用于检查与身体功能变化相关的预处理特征。
在 42%的参与者中，有 47%的人在化疗结束时从基线下降的身体功能在 12 个月时恢复（具有恢复力）。几乎三分之一的人在化疗前到 12 个月后经历了功能下降。化疗前的疲劳是化疗前至化疗结束时功能下降的危险因素（P=.02）。12 个月时功能下降的危险因素包括化疗前的呼吸困难（P=.007）和未婚（P=.01）。
在临床试验中，接受辅助化疗的老年乳腺癌女性身体功能下降较为常见。尽管有一半人恢复了身体功能，但三分之一的人在 12 个月时有明显的功能下降。需要采取策略来预防接受化疗的老年人的功能下降。美国老年医学会 67：920-927，2019 年。
