Age of menopause among women who remain premenopausal following treatment for early breast cancer: Long-term results from International Breast Cancer Study Group Trials V and VI
Age of menopause among women who remain premenopausal following treatment for early breast cancer: Long-term results from International Breast Cancer Study Group Trials V and VI
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DOI：
10.1016/j.ejca.2007.04.006
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发表时间：
2007-07-01
影响因子：
8.4
通讯作者：
Winer, Eric
中科院分区：
文献类型：
--
作者：
Partridge, Ann;Gelber, Shari;Winer, Eric
背景：对于乳腺癌辅助化疗后仍处于绝经前状态的女性，过早绝经的可能性尚未得到彻底探讨。方法：我们使用了国际乳腺癌研究组 (IBCSG) 试验 V 和 VI 的数据。试验 V 纳入了 1407 名符合条件的绝经前女性，随机分配不接受全身治疗（无 CT）或如果淋巴结阴性则接受 1 个周期的围手术期基于 CMF 的化疗 (PeCT)，如果淋巴结阳性则接受 6 个周期的术后基于 CMF 的化疗 (CMF x 6) 或 1 个周期的围手术期基于 CMF 的化疗加术后 CMF x 6 (CMF x 7)。从试验 VI（一项 2 x 2 析因设计研究，对 3 个与 6 个初始 CMF 周期进行比较，并重新引入另外三个 CMF 疗程），我们纳入了 375 名女性，随机分配仅接受 6 个初始 CMF 周期 (CMF x 6)。结果：我们排除了随机分组后 (N = 934)、子宫切除术 (N = 16) 或双侧卵巢切除术 (N = 8) 或缺失月经数据 (N = 57) 后 12-24 个月内报告没有月经的女性，创建了一个由 767 名女性组成的队列； 540 名女性被随机分配至 PeCT 或无 CT，227 名女性被随机分配至 CMF x 6 或 7。Cox 比例风险模型显示，CMF x 6 或 7（HR = 2.03，p < 0.0001）和暂时性闭经（HR = 1.96，p < 0.0001）与过早绝经相关。解释：经过 6 或 7 个周期的基于 CMF 的化疗后仍处于绝经前的女性，比接受很少或未接受化疗的女性更早进入更年期。月经暂时停止似乎是更年期提前的一个标志。这些发现可能有助于女性和临床医生在诊断出乳腺癌后做出治疗和生殖决定。 (c) 2007 Elsevier Ltd. 保留所有权利。
Background: The likelihood of Premature menopause has not been thoroughly explored in women who remain premenopausal after adjuvant chemotherapy for breast cancer. Methods: We used data from the International Breast Cancer Study Group (IBCSG) Trials V and VI. Trial V enrolled 1407 eligible premenopausal women randomised to no systemic therapy (No CT) or 1 cycle of perioperative CMF-based chemotherapy (PeCT) if node negative, and 6 cycles of CMF-based chemotherapy postoperatively (CMF x 6) or 1 cycle perioperative CMF-based chemotherapy plus CMF x 6 postoperatively (CMF x 7) if node positive. From Trial VI (a 2 x 2 factorial designed study of 3 versus 6 initial cycles of CMF and a reintroduction of three additional courses of CMF), we included 375 women randomised to receive only six initial cycles of CMF (CMF x 6). Findings: We excluded women who reported no menses during 12-24 months after randomisation (N = 934), hysterectomy (N = 16) or bilateral oophorectomy (N = 8), or missing menses data (N = 57), creating a cohort of 767 women; 540 women had been randomised to PeCT or no CT, 227 randomised to CMF x 6 or 7. A Cox proportional hazards model revealed that CMF x 6 or 7 (HR = 2.03, p < 0.0001) and temporary amenorrhea (HR = 1.96, p < 0.0001) were associated with Premature menopause. Interpretation: Women who remain premenopausal after 6 or 7 cycles of CMF-based chemotherapy have a higher likelihood of going through menopause at an earlier age than women who received little or no chemotherapy Temporary cessation of menses appears to be a marker for earlier onset of menopause. These findings may assist women and clinicians when making treatment and reproductive decisions after a diagnosis of breast cancer. (c) 2007 Elsevier Ltd. All rights reserved.