Prognostic role of amenorrhea induced by adjuvant chemotherapy in premenopausal patients with early breast cancer.
Prognostic role of amenorrhea induced by adjuvant chemotherapy in premenopausal patients with early breast cancer.
复制标题
DOI：
10.1038/bjc.1991.177
复制
发表时间：
1991-05
影响因子：
8.8
通讯作者：
De Placido, S
中科院分区：
文献类型：
--
作者：
Bianco, A R;Del Mastro, L;Gallo, C;Perrone, F;Matano, E;Pagliarulo, C;De Placido, S
在254例连续接受辅助CMF或含CMF方案治疗的绝经前患者中，对221例药物性闭经（DIA）的预后作用进行了评估; 33例患者因缺乏月经数据而被排除。所有患者均有转移性腋窝淋巴结;药物方案为：CMF x 9个疗程+/-他莫昔芬（TM）和CMF x 6个疗程;中位年龄为43岁（范围26-54）。绝经前状态定义为开始化疗前6周内的末次正常月经：DIA定义为从化疗结束起至少3个月内月经停止。166，221例（75.1%）患者发生DIA，与患者年龄严格相关;此外，患者年龄越大，发生DIA所需的时间越短。中位随访69个月，Mantel-Byar分析显示，与非闭经妇女相比，DIA患者的无病生存期（DFS）较长（P <0.001）。通过考克斯模型评估，DIA的预后价值与年龄、受累淋巴结数量、肿瘤大小和CMF周期数无关（RH 0.43，95% C.I. 0.24-0.77），其中DIA作为时间依赖性协变量输入。
The prognostic role of drug-induced amenorrhea (DIA) was restrospectively evaluated in 221 out of 254 consecutive premenopausal patients treated with adjuvant CMF or a CMF-containing regimen; 33 patients were eliminated because of lack of menstrual data. All patients had metastatic axillary nodes; drug regimens were: CMF x 9 courses +/- Tamoxifen (TM) and CMF x 6 courses; median age was 43 (range 26-54). Premenopausal status was defined as last normal menses within the 6 weeks preceding initiation of chemotherapy: DIA as cessation of menses for at least 3 months not later than 3 months from the end of chemotherapy. DIA occurred in 166,221 (75.1%) patients and was strictly related to the age of the patients; also, the older the patients the shorter the time required to develop DIA. At median follow up of 69 months, Mantel-Byar analysis showed a longer disease free survival (DFS) for patients who developed DIA as compared with non amenorrheic women (P less than 0.001). DIA prognostic value was independent of age, number of involved nodes, tumour size and number of CMF cycles, as assessed by the Cox model (RH 0.43, 95% C.I. 0.24-0.77), in which DIA was entered as a time dependent covariate.