Son Kyung-Lak, Shin Joon Sung, Lee Sun Hyung, Lee Sungwon, Jung Saim, Kim Won-Hyoung, Jung Dooyoung, Kim Tae-Yong, Im Seock-Ah, Lee Kyung-Hun, Hahm Bong-Jin, Yeom Chan-Woo
Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
Support Care Cancer. 2024 Jul 13;32(8):511. doi: 10.1007/s00520-024-08718-6.
We assessed the differences in chemotherapy-induced nausea and vomiting (CINV) severity in patients with breast cancer, receiving neoadjuvant chemotherapy (NAC) and adjuvant chemotherapy (AC).
CINV severity in patients on anthracycline-based NAC (n = 203) and AC (n = 79) was assessed at baseline (C0) and after the first and fourth chemotherapy using a 10-point Likert scale. Group-by-time interaction term was used to evaluate the effect of the group on changes in CIN (cCIN) and CIV (cCIV) from C0 to the follow-up periods (C1, C4). If insignificant, group effects were analyzed without the interaction term. Subgroup analysis was performed based on age 50. In statistical analyses, sociodemographic and clinical variables that differed between groups were adjusted for.
The effect of group by follow-up period was not significant in cCIN and cCIV. The AC group showed a significantly higher change in the severity of cCIN compared to the NAC group (estimated mean = 1.133, 95% CI = 0.104-2.161, p = 0.031), but there was no difference in cCIV. In those ≤ 50 years, significant differences in cCIN severity (estimated mean = 1.294, 95% CI = 0.103-2.484, p = 0.033) were observed, but not in cCIV. In those > 50 years, neither cCIN nor cCIV differed significantly between groups.
NAC in breast cancer patients showed less severe CIN than adjuvant chemotherapy AC, but not in those over 50. Clinicians should recognize that the severity of CIN may vary across different chemotherapy settings and adjust their management accordingly.
The clinical trial registration ( www.
gov ) numbers were NCT01887925 (the registration date is from June 20, 2013, to November 27, 2015) and NCT02011815 (the registration date is from December 10, 2013, to September 22, 2019).
我们评估了接受新辅助化疗（NAC）和辅助化疗（AC）的乳腺癌患者化疗引起的恶心和呕吐（CINV）严重程度的差异。
使用10分制李克特量表在基线（C0）以及首次和第四次化疗后评估接受蒽环类药物为基础的NAC（n = 203）和AC（n = 79）患者的CINV严重程度。使用组-时间交互项来评估组对从C0到随访期（C1、C4）的化疗引起的恶心（cCIN）和化疗引起的呕吐（cCIV）变化的影响。如果不显著，则在不使用交互项的情况下分析组效应。根据年龄50岁进行亚组分析。在统计分析中，对组间不同的社会人口统计学和临床变量进行了调整。
随访期的组效应在cCIN和cCIV中不显著。与NAC组相比，AC组的cCIN严重程度变化显著更高（估计均值 = 1.133，95%可信区间 = 0.104 - 2.161，p = 0.031），但cCIV没有差异。在年龄≤50岁的患者中，观察到cCIN严重程度有显著差异（估计均值 = 1.294，95%可信区间 = 0.103 - 2.484，p = 0.033），但cCIV没有差异。在年龄>50岁的患者中，组间cCIN和cCIV均无显著差异。
乳腺癌患者的NAC引起的CIN比辅助化疗AC轻，但50岁以上患者并非如此。临床医生应认识到CIN的严重程度在不同化疗环境中可能有所不同，并相应调整管理措施。
