Vitamin supplement use during breast cancer treatment and survival: a prospective cohort study.
Vitamin supplement use during breast cancer treatment and survival: a prospective cohort study.
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乳腺癌治疗和生存期间维生素补充剂的使用：一项前瞻性队列研究。
DOI：
10.1158/1055-9965.epi-10-1072
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发表时间：
2011-02
期刊：
影响因子：
--
通讯作者：
Shu XO
中科院分区：
文献类型：
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作者：
Nechuta S;Lu W;Chen Z;Zheng Y;Gu K;Cai H;Zheng W;Shu XO
抗氧化剂可以保护正常细胞免受放射治疗和某些化疗方案中发生的氧化损伤，然而，同样的机制也可以保护肿瘤细胞，并可能降低癌症治疗的有效性。我们评估了乳腺癌诊断后的前六个月和癌症治疗期间维生素补充剂的使用与总死亡率和复发率的关系。我们在2002年3月至2006年4月期间在中国上海进行了一项基于人群的前瞻性队列研究，研究对象为4877名年龄在20-75岁之间被诊断为浸润性乳腺癌的女性。在诊断后约6个月对妇女进行访谈，并通过面对面访谈和与生命统计登记处的记录联系进行随访。在平均4.1年的随访中，444人死亡，532人复发。根据多种生活方式因素、社会人口统计和已知的临床预后因素进行调整后，乳腺癌诊断后不久服用维生素与降低死亡率和复发风险相关。服用抗氧化剂（维生素E、维生素C、多种维生素）的妇女死亡率降低18%(风险比（HR) = 0.82, 95%可信区间（CI）： 0.65-1.02），复发风险降低22% （HR = 0.78, 95% CI: 0.63-0.95）。与化疗同时或不同时使用维生素无关，但仅存在于未接受放疗的患者中。在乳腺癌诊断后的前六个月服用维生素补充剂可能与降低死亡率和复发率有关。我们的研究结果不支持目前的建议，即乳腺癌患者应避免使用维生素补充剂。
Antioxidants may protect normal cells from the oxidative damage that occurs during radiotherapy and certain chemotherapy regimens, however, the same mechanism could protect tumor cells and potentially reduce effectiveness of cancer treatments. We evaluated the association of vitamin supplement use in the first six-months after breast cancer diagnosis and during cancer treatment with total mortality and recurrence. We conducted a population-based prospective cohort study of 4,877 women aged 20–75 years diagnosed with invasive breast cancer in Shanghai, China between March 2002 and April 2006. Women were interviewed approximately six-months after diagnosis and followed-up by in-person interviews and record linkage with the vital statistics registry. During a mean follow-up of 4.1 years, 444 deaths and 532 recurrences occurred. Vitamin use shortly after breast cancer diagnosis was associated with reduced mortality and recurrence risk, adjusted for multiple lifestyle factors, sociodemographics, and known clinical prognostic factors. Women who used antioxidants (vitamin E, vitamin C, multivitamins) had 18% reduced mortality risk (hazard ratio (HR) = 0.82, 95% confidence interval (CI): 0.65–1.02) and 22% reduced recurrence risk (HR = 0.78, 95% CI: 0.63–0.95). The inverse association was found regardless of whether vitamin use was concurrent or non-concurrent with chemotherapy, but was only present among patients who did not receive radiotherapy. Vitamin supplement use in the first six months after breast cancer diagnosis may be associated with reduced risk of mortality and recurrence. Our results do not support the current recommendation that breast cancer patients should avoid use of vitamin supplements.