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化疗诱导的绝经对有生育能力的非转移性乳腺癌女性的影响 - MENOCOR 研究的初步结果。

Impact of Chemotherapy-induced Menopause in Women of Childbearing Age With Non-metastatic Breast Cancer - Preliminary Results From the MENOCOR Study.

机构信息

Université Clermont Auvergne, Centre Jean Perrin, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont-Ferrand, France.

Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest en Jarez, France.

出版信息

Clin Breast Cancer. 2019 Feb;19(1):e74-e84. doi: 10.1016/j.clbc.2018.10.003. Epub 2018 Oct 23.

Abstract

BACKGROUND

Young patients with breast cancer treated with chemotherapy can experience ovarian failure, which can lead to chemotherapy-induced menopause (CIM) impacting the quality of life (QoL). A prospective study was set out to evaluate the impact of CIM on QoL in women of childbearing age with non-metastatic breast cancer, and this article reports results of the interim analysis conducted to evaluate feasibility and to see preliminary results.

PATIENTS AND METHODS

A total of 58 women (age, 18-46 years) with newly diagnosed breast cancer and treated with chemotherapy were eligible. QoL was assessed by self-administered questionnaires (Quality of Life Questionnaire-Core 30 [QLQ-C30], Quality of Life Questionnaire-Breast 23 [QLQ-BR23], and Kupperman index) and hormonal variations (anti-Müllerian hormone [AMH], follicle-stimulating hormone, and estradiol) were explored. We compared patients with ≥ 12 months amenorrhea (CIM) (n = 41) to patients with < 12 months of amenorrhea (non-CIM) (n = 17).

RESULTS

A good inclusion rate (approximately 4/month) and sufficient data enabled us to perform this analysis. QLQ-C30 failed to show any difference between CIM and non-CIM patients (P = .5). In contrast, at 6 months post-chemotherapy, CIM patients tended to have lower QoL as shown by QLQ-BR23 (P = .16) and more severe climacteric symptoms (P = .01). Regarding hormonal variations, AMH pre-treatment level was higher in non-CIM patients (P = .0032). We also noted that CIM patients were older (P = .00013), had shorter menstruation cycle (P = .082), and experienced faster amenorrhea (P = .088).

CONCLUSIONS

The study is technically feasible, and our preliminary results underline that age in association with pre-treatment AMH level could be helpful to predict ovarian function. QLQ-BR23 seemed to be stronger, more precise, and appropriate to evaluate QoL changes in patients with breast cancer than the QLQ-C30.

摘要

背景

接受化疗的年轻乳腺癌患者可能会经历卵巢衰竭,从而导致化疗引起的更年期(CIM),影响生活质量(QoL)。本研究旨在评估 CIM 对非转移性乳腺癌育龄期女性生活质量的影响,这是一项前瞻性研究,本文报道了中期分析的结果,以评估其可行性并获得初步结果。

患者和方法

共纳入 58 例年龄 18-46 岁的新诊断乳腺癌患者,接受化疗。通过自我管理问卷(核心 30 生活质量问卷 [QLQ-C30]、乳房 23 生活质量问卷 [QLQ-BR23] 和库珀曼指数)评估生活质量,并探讨了激素变化(抗苗勒管激素 [AMH]、卵泡刺激素和雌二醇)。我们比较了≥12 个月闭经(CIM)(n=41)与<12 个月闭经(非 CIM)(n=17)患者。

结果

良好的纳入率(约每月 4 例)和充足的数据使我们能够进行这项分析。QLQ-C30 未能显示 CIM 和非 CIM 患者之间的任何差异(P=0.5)。相反,在化疗后 6 个月,CIM 患者的 QLQ-BR23 评分较低(P=0.16),更年期症状更严重(P=0.01)。关于激素变化,非 CIM 患者的 AMH 预处理水平较高(P=0.0032)。我们还注意到 CIM 患者年龄较大(P=0.00013)、月经周期较短(P=0.082)和闭经较快(P=0.088)。

结论

该研究在技术上是可行的,我们的初步结果表明,年龄与预处理 AMH 水平相结合可能有助于预测卵巢功能。QLQ-BR23 似乎比 QLQ-C30 更强、更精确、更适合评估乳腺癌患者的生活质量变化。

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