Division of Oncology, School of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive, Campus Box 7305, Chapel Hill, NC, 27599-7305, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Breast Cancer Res Treat. 2022 Jan;191(2):409-422. doi: 10.1007/s10549-021-06439-6. Epub 2021 Nov 5.
It is not known whether chemotherapy-related symptom experiences differ between Black and White women with early breast cancer (Stage I-III) receiving current chemotherapy regimens and, in turn, influences dose delay, dose reduction, early treatment discontinuation, or hospitalization.
Patients self-reported their race and provided symptom reports for 17 major side effects throughout chemotherapy. Toxicity and adverse events were analyzed separately for anthracycline and non-anthracycline regimens. Fisher's exact tests and two-sample t-tests compared baseline patient characteristics. Modified Poisson regression estimated relative risks of moderate, severe, or very severe (MSVS) symptom severity, and chemotherapy-related adverse events.Please check and confirm that the authors and their respective affiliations have been correctly identified and amend if necessary.no changes RESULTS: In 294 patients accrued between 2014 and 2020, mean age was 58 (SD13) and 23% were Black. For anthracycline-based regimens, the only significant difference in MSVS symptoms was in lymphedema (41% Black vs 20% White, p = .04) after controlling for axillary surgery. For non-anthracycline regimens, the only significant difference was MSVS peripheral neuropathy (41% Blacks vs. 23% White) after controlling for taxane type (p = .05) and diabetes (p = .05). For all other symptoms, severity scores were similar. Dose reduction differed significantly for non-anthracycline regimens (49% Black vs. 25% White, p = .01), but not for anthracycline regimens or in dose delay, early treatment discontinuation, or hospitalization for either regimen.
Except for lymphedema and peripheral neuropathy, Black and White patients reported similar symptom severity during adjuvant chemotherapy. Dose reductions in Black patients were more common for non-anthracycline regimens. In this sample, there were minimal differences in patient-reported symptoms and other adverse outcomes in Black versus White patients.
目前尚不清楚接受当前化疗方案的早期乳腺癌(I-III 期)的黑人和白人女性之间是否存在化疗相关症状体验的差异,而这些差异又会影响剂量延迟、剂量减少、早期治疗终止或住院。
患者在化疗期间自我报告种族,并提供 17 种主要副作用的症状报告。分别分析蒽环类和非蒽环类方案的毒性和不良事件。Fisher 确切检验和两样本 t 检验比较基线患者特征。采用修正泊松回归估计中、重度或非常重度(MSVS)症状严重程度和化疗相关不良事件的相对风险。
在 2014 年至 2020 年间入组的 294 名患者中,平均年龄为 58(SD13)岁,23%为黑人。对于基于蒽环类的方案,在控制腋窝手术后,仅在淋巴水肿(41%黑人 vs 20%白人,p = .04)方面存在 MSVS 症状的显著差异。对于非蒽环类方案,在控制紫杉烷类型(p = .05)和糖尿病(p = .05)后,唯一显著差异是 MSVS 周围神经病(41%黑人 vs. 23%白人)。对于所有其他症状,严重程度评分相似。非蒽环类方案的剂量减少差异显著(49%黑人 vs. 25%白人,p = .01),但蒽环类方案或剂量延迟、早期治疗终止或两种方案的住院治疗没有差异。
除了淋巴水肿和周围神经病外,黑人和白人患者在辅助化疗期间报告的症状严重程度相似。非蒽环类方案中,黑人患者的剂量减少更为常见。在这个样本中,黑人和白人患者在患者报告的症状和其他不良结局方面差异极小。