Song Jiaqing, Jin Ying, Yu Qinghong, Wu Hongting, Li Hailong, Lim Geok Hoon, Antonini Marcelo, Gao Xiufei
The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
School of Green Intelligent Pharmaceutical, Zhejiang Guangsha Vocational and Technical University of Construction, Jinhua, China.
Transl Cancer Res. 2025 Mar 30;14(3):1952-1970. doi: 10.21037/tcr-2024-2658. Epub 2025 Mar 18.
Breast cancer is the second most common cancer worldwide. Chemotherapy often causes dyslipidemia and obesity in breast cancer patients. Monitoring lipid profiles and body mass index (BMI) is crucial to evaluate chemotherapy's metabolic side effects, identify interventions to mitigate them, and understand health risks linked to weight changes during treatment. Shenling Baizhu Powder (SLBZP), a traditional Chinese medicine (TCM), treats spleen-stomach ailments by boosting spleen function, enhancing qi, and reducing dampness. SLBZP has potential benefits in managing chemotherapy-induced dyslipidemia and improving overall metabolic health in cancer patients. This study retrospectively examined the effects of SLBZP on blood lipid levels and BMI in breast cancer patients undergoing adjuvant chemotherapy.
This study reviewed the medical records of patients who were diagnosed with breast cancer at the Breast Surgery Department of Zhejiang Provincial Hospital of Traditional Chinese Medicine from January 2022 to December 2023. Based on the inclusion criteria, a total of 180 eligible patients were included and divided into an observational group (which received SLBZP) and a control group (which did not receive SLBZP) during chemotherapy. Patients' clinical data, including age at diagnosis, menopausal status, tumor location, smoking and drinking habits, tumor molecular type, tumor node metastasis (TNM) stage, chemotherapy drugs, targeted therapy, lipid levels, and BMI before and after chemotherapy, were collected. Statistical analyses were conducted using SPSS 25.0.
After chemotherapy, the control group showed significant increases in total cholesterol (TC) (P=0.03), triglyceride (TG) (P=0.001), low-density lipoprotein cholesterol (LDL-C) (P=0.02), and apolipoprotein B (ApoB) (P=0.01) levels. In the observational group, the TC, TG, and LDL-C levels remained stable (P>0.05), but the high-density lipoprotein cholesterol (HDL-C) (P=0.001) and apolipoprotein A1 (ApoA1) (P<0.001) levels significantly decreased, and BMI (P=0.02) significantly increased. The subgroup analysis revealed that the taxane followed by anthracycline subgroup showed significant increases in BMI (P=0.007) and significant decreases in the HDL-C (P=0.007) and ApoA1 (P<0.001) levels, while the taxane subgroup showed a significant decrease in the HDL-C level post-chemotherapy (P=0.003). In the control group, the TG (P=0.002) and LDL-C (P=0.02) levels were significantly elevated in the taxane followed by anthracycline subgroup post-chemotherapy. No significant changes were observed in BMI or the other lipid indexes in the remaining chemotherapy drug regime subgroups (P>0.05).
Chemotherapy increased the TC, TG, LDL-C, and ApoB levels in breast cancer patients, but SLBZP mitigated dyslipidemia. The patients who received SLBZP also showed increased BMI post-chemotherapy, which was likely due to reduced gastrointestinal side effects. Taxane-based chemotherapy drugs had greater effects on blood lipids and BMI, while anthracycline-based drugs did not significantly affect blood lipids and BMI.
乳腺癌是全球第二大常见癌症。化疗常导致乳腺癌患者出现血脂异常和肥胖。监测血脂谱和体重指数(BMI)对于评估化疗的代谢副作用、确定减轻这些副作用的干预措施以及了解治疗期间体重变化相关的健康风险至关重要。参苓白术散(SLBZP)是一种中药,通过增强脾胃功能、益气和祛湿来治疗脾胃疾病。SLBZP在管理化疗引起的血脂异常和改善癌症患者的整体代谢健康方面具有潜在益处。本研究回顾性分析了SLBZP对接受辅助化疗的乳腺癌患者血脂水平和BMI的影响。
本研究回顾了2022年1月至2023年12月在浙江省中医院乳腺外科诊断为乳腺癌的患者的病历。根据纳入标准,共纳入180例符合条件的患者,并在化疗期间分为观察组(接受SLBZP)和对照组(未接受SLBZP)。收集患者的临床资料,包括诊断时年龄、绝经状态、肿瘤位置、吸烟和饮酒习惯、肿瘤分子类型、肿瘤淋巴结转移(TNM)分期、化疗药物、靶向治疗、化疗前后的血脂水平和BMI。使用SPSS 25.0进行统计分析。
化疗后,对照组的总胆固醇(TC)(P = 0.03)、甘油三酯(TG)(P = 0.001)、低密度脂蛋白胆固醇(LDL-C)(P = 0.02)和载脂蛋白B(ApoB)(P = 0.01)水平显著升高。在观察组中,TC、TG和LDL-C水平保持稳定(P > 0.05),但高密度脂蛋白胆固醇(HDL-C)(P = 0.001)和载脂蛋白A1(ApoA1)(P < 0.001)水平显著降低,BMI(P = 0.02)显著升高。亚组分析显示,紫杉烷序贯蒽环类药物亚组的BMI显著升高(P = 0.007),HDL-C(P = 0.007)和ApoA1(P < 0.001)水平显著降低,而紫杉烷亚组化疗后HDL-C水平显著降低(P = 0.003)。在对照组中,紫杉烷序贯蒽环类药物亚组化疗后TG(P = 0.002)和LDL-C(P = 0.02)水平显著升高。其余化疗药物方案亚组的BMI或其他血脂指标无显著变化(P > 0.05)。
化疗增加了乳腺癌患者的TC、TG、LDL-C和ApoB水平,但SLBZP减轻了血脂异常。接受SLBZP的患者化疗后BMI也有所增加,这可能是由于胃肠道副作用减少所致。基于紫杉烷的化疗药物对血脂和BMI的影响更大,而基于蒽环类的药物对血脂和BMI无显著影响。