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为什么女性在接受乳腺癌辅助化疗时会体重增加。

Why women gain weight with adjuvant chemotherapy for breast cancer.

作者信息

Demark-Wahnefried W, Winer E P, Rimer B K

机构信息

Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, NC 27710.

出版信息

J Clin Oncol. 1993 Jul;11(7):1418-29. doi: 10.1200/JCO.1993.11.7.1418.

Abstract

PURPOSE

Among breast cancer patients receiving adjuvant chemotherapy, weight gain is a common side effect that may decrease quality of life and potentially threaten survival. Weight gain during treatment is a problem that is clinically well appreciated, and one that has been studied by a number of investigators.

DESIGN

A literature review was conducted to address each of the following issues: (1) the prevalence and magnitude of weight gain in women receiving adjuvant chemotherapy for early-stage breast cancer, (2) factors that might affect the amount of weight gained, (3) adverse consequences of weight gain, (4) mechanisms potentially responsible for weight gain, and (5) current dietary intervention programs directed toward women receiving adjuvant chemotherapy.

RESULTS

Weight gain is associated with a number of adverse effects in breast cancer patients receiving adjuvant chemotherapy. Weight gains are exaggerated in premenopausal women and women receiving multiagent regimens. Little research has been conducted to investigate the underlying mechanisms that contribute to weight gain in this population.

CONCLUSION

Interventions to prevent weight gain during adjuvant chemotherapy are underway; however, little research has been conducted to investigate the underlying mechanisms of energy imbalance. Although changes in resting metabolic rate, thermogenesis, physical activity, and dietary intake are all plausible, no firm data exist to support any of these mechanisms. There is a need for research that explores the relative contribution of each of these factors to energy imbalance, so that optimally effective interventions can be created and implemented to combat this problem.

摘要

目的

在接受辅助化疗的乳腺癌患者中,体重增加是一种常见的副作用,可能会降低生活质量并潜在威胁生存。治疗期间体重增加是一个临床上得到充分认识的问题,并且已经有许多研究者对其进行了研究。

设计

进行了一项文献综述,以探讨以下每个问题:(1)早期乳腺癌接受辅助化疗的女性体重增加的发生率和幅度;(2)可能影响体重增加量的因素;(3)体重增加的不良后果;(4)体重增加潜在的机制;(5)针对接受辅助化疗的女性的当前饮食干预方案。

结果

在接受辅助化疗的乳腺癌患者中,体重增加与多种不良影响相关。绝经前女性和接受多药联合方案的女性体重增加更为明显。对于导致该人群体重增加的潜在机制,几乎没有进行过研究。

结论

目前正在开展预防辅助化疗期间体重增加的干预措施;然而,对于能量失衡的潜在机制,几乎没有进行过研究。尽管静息代谢率、产热、身体活动和饮食摄入的变化都有可能,但尚无确凿数据支持这些机制中的任何一种。需要开展研究来探索这些因素各自对能量失衡的相对贡献,以便制定并实施最佳有效的干预措施来解决这一问题。

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