Predictors of Discontinuation of Adjuvant Hormone Therapy in Patients With Breast Cancer
Predictors of Discontinuation of Adjuvant Hormone Therapy in Patients With Breast Cancer
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DOI：
10.1200/jco.2014.59.3673
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发表时间：
2015-07-10
影响因子：
45.3
通讯作者：
Czene, Kamila
中科院分区：
文献类型：
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作者：
He, Wei;Fang, Fang;Czene, Kamila
PurposeTo找出预测因素的辅助激素治疗的患者乳腺cancer.Patients和MethodsWe进行了一项记录连锁研究的基础上，从斯德哥尔摩-哥特兰乳腺癌登记处，瑞典处方药登记处的数据，和自我报告的问卷调查。在2005年至2008年期间，在瑞典斯德哥尔摩被诊断患有乳腺癌的妇女被前瞻性地随访了5年，直到2013年，从她们第一次服用他莫昔芬或芳香酶抑制剂开始结果卵巢癌家族史（风险比[HR]，1.55; 95% CI，1.19 - 2.02）;年轻（< 40岁; HR，1.39; 95% CI，1.08至1.78）及以上（65岁; HR，1.15; 95% CI，1.03 - 1.28）年龄;较高的Charlson合并症指数（2 v 0; HR，1.35; 95% CI，1.03 - 1.76）;和使用镇痛药（HR，1.33; 95% CI，1.16 - 1.52），催眠药/镇静剂（HR，1.24; 95% CI，1.07 - 1.43），GI药物（HR，1.25; 95% CI，1.08 - 1.43）和激素替代治疗（HR，1.27; 95% CI，1.08 - 1.49）被确定为激素治疗中止的基线预测因素。使用镇痛药（HR，1.22; 95% CI，1.08 - 1.37），催眠药/镇静剂（HR，1.21; 95% CI，1.07 - 1.37），抗抑郁药（HR，1.22; 95% CI，1.06 - 1.40）或GI药物（HR，1.27; 95% CI，1.13 - 1.43），以及他莫昔芬和芳香酶抑制剂之间的转换治疗（HR，1.50; 95%可信区间，1.23至1.83）在激素治疗的第一年，与在未来4年中断的风险增加。结论在我们的研究中确定的预测因子可用于制定有针对性的干预，以防止辅助治疗停止激素治疗，随后改善乳腺癌的结果。(C)2015年美国临床肿瘤学会
PurposeTo identify predictors of discontinuation of adjuvant hormone therapy in patients with breast cancer.Patients and MethodsWe conducted a record-linkage study based on data from Stockholm-Gotland Breast Cancer Register, Swedish Prescribed Drug Register, and self-reported questionnaire. Women diagnosed with breast cancer between 2005 and 2008 in Stockholm, Sweden, were prospectively followed for 5 years until 2013, starting from their first prescription of tamoxifen or aromatase inhibitors (N = 3,395).ResultsFamily history of ovarian cancer (hazard ratio [HR], 1.55; 95% CI, 1.19 to 2.02); younger (< 40 years; HR, 1.39; 95% CI, 1.08 to 1.78) and older ( 65 years; HR, 1.15; 95% CI, 1.03 to 1.28) age; higher Charlson comorbidity index ( 2 v 0; HR, 1.35; 95% CI, 1.03 to 1.76); and use of analgesics (HR, 1.33; 95% CI, 1.16 to 1.52), hypnotics/sedatives (HR, 1.24; 95% CI, 1.07 to 1.43), GI drugs (HR, 1.25; 95% CI, 1.08 to 1.43), and hormone replacement therapy (HR, 1.27; 95% CI, 1.08 to 1.49) were identified as baseline predictors for hormonal treatment discontinuation. Use of analgesics (HR, 1.22; 95% CI, 1.08 to 1.37), hypnotics/sedatives (HR, 1.21; 95% CI, 1.07 to 1.37), antidepressants (HR, 1.22; 95% CI, 1.06 to 1.40), or GI drugs (HR, 1.27; 95% CI, 1.13 to 1.43), and switching therapy between tamoxifen and aromatase inhibitors (HR, 1.50; 95% CI, 1.23 to 1.83) during the first year of hormonal treatment were associated with increased risk of discontinuation during the next 4 years.ConclusionPredictors identified in our study can be used in developing targeted intervention to prevent adjuvant hormone therapy discontinuation and subsequently to improve breast cancer outcomes. (C) 2015 by American Society of Clinical Oncology