Cathcart C K, Jones S E, Pumroy C S, Peters G N, Knox S M, Cheek J H
Sammons Cancer Center, Baylor University Medical Center, Dallas, Texas 75246.
Breast Cancer Res Treat. 1993 Sep;27(3):277-81. doi: 10.1007/BF00665698.
Depression is not an uncommon complaint of women with breast cancer and is usually assumed to be related to the cancer diagnosis itself or its treatment. As part of a prospective clinical trial of adjuvant therapy of node negative breast cancer, 301 patients treated and assessed by one oncologist (SEJ) were serially questioned for symptoms of depression in the first 6-12 months after completing initial treatment (surgery, radiation therapy, and/or chemotherapy). Two hundred and fifty-seven patients were evaluable for assessment of depression; 155 were receiving tamoxifen and 102 were not. Twenty-six patients had symptoms of depression including 23 (15%) treated with tamoxifen compared to 3 (3%) in the group not placed on tamoxifen (p < 0.005). Of the 23 patients with depression in the tamoxifen group, symptoms were temporally related to the initiation of therapy and occurred generally in the first 2 months of treatment. Eight patients had mild symptoms not requiring a dose reduction, 8 had significant depression requiring a dose reduction to relieve symptoms, and 7 required discontinuation of tamoxifen. We conclude that clinical depression as a side effect of tamoxifen therapy may be more common than previously believed and should be further rigorously investigated to confirm or deny our clinical impressions.
抑郁症是乳腺癌女性患者中较为常见的主诉，通常被认为与癌症诊断本身或其治疗有关。作为一项关于淋巴结阴性乳腺癌辅助治疗的前瞻性临床试验的一部分，由一名肿瘤学家（SEJ）治疗和评估的301名患者在完成初始治疗（手术、放疗和/或化疗）后的最初6至12个月内被连续询问是否有抑郁症状。257名患者可用于评估抑郁症；155名接受他莫昔芬治疗，102名未接受。26名患者有抑郁症状，其中23名（15%）接受他莫昔芬治疗，而未接受他莫昔芬治疗的组中有3名（3%）（p<0.005）。在他莫昔芬组的23名抑郁症患者中，症状在时间上与治疗开始有关，通常发生在治疗的前2个月。8名患者有轻度症状，无需减量，8名有严重抑郁症，需要减量以缓解症状，7名需要停用他莫昔芬。我们得出结论，作为他莫昔芬治疗副作用的临床抑郁症可能比以前认为的更常见，应进一步进行严格研究以证实或否定我们的临床印象。
