Fatigue, menopausal symptoms, and cognitive function in women after adjuvant chemotherapy for breast cancer:: 1-and 2-year follow-up of a prospective controlled study
Fatigue, menopausal symptoms, and cognitive function in women after adjuvant chemotherapy for breast cancer:: 1-and 2-year follow-up of a prospective controlled study
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DOI：
10.1200/jco.2005.01.6550
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发表时间：
2005-11-01
影响因子：
45.3
通讯作者：
Tannock, IF
中科院分区：
文献类型：
--
作者：
Fan, HGM;Houédé-Tchen, N;Tannock, IF
我们之前评估了接受辅助治疗的乳腺癌患者和匹配的健康女性的疲劳、更年期症状和认知功能障碍。在这里，我们报告了这些妇女1年和2年后的评估。患者和方法采用癌症治疗功能评估-一般生活质量问卷、疲劳和内分泌症状亚量表以及高灵敏度认知筛查对无复发患者和对照组进行评估。结果分别有104例、91例和83例患者和102例、81例和81例对照者在基线和1年和2年进行评估。癌症治疗的中位功能评估-疲劳评分（范围，0 - 52）在1年和2年分别从31分（化疗组）改善到43分和45分，但对照组保持稳定（46 - 48分）。癌症治疗-内分泌症状的中位功能评估评分（范围，0 - 72）在1年和2年分别从57分（化疗组）改善到59分和61分，对照组稳定（64 - 65分）。在这些量表上，患者和对照组之间的差异仍然显著。在1年和2年期间，通过高灵敏度认知筛查，患者中重度认知功能障碍的发生率分别从16%（化疗组）下降到4.4%和3.8%，对照组从5%下降到3.6%和0%。化疗后开始激素治疗（主要是他莫昔芬）的雌激素受体阳性患者与未开始激素治疗的雌激素受体阴性患者之间的差异很小。患者和对照组之间的生活质量差异仅在基线时显著。结论疲劳、更年期症状和认知功能障碍是化疗后的主要不良反应，多数患者均有改善。激素治疗对他们的影响很小。
Purpose We previously evaluated fatigue, menopausal symptoms, and cognitive dysfunction in patients receiving adjuvant therapy for breast cancer and matched healthy women. Here we report assessment of these women 1 and 2-years later.Patients and Methods Patients without relapse and controls were evaluated by the Functional Assessment of Cancer Treatment-General Quality of Life questionnaire, with subscales for fatigue and endocrine symptoms, and by the High Sensitivity Cognitive Screen.Results There were 104, 91, and 83 patients and 102, 81, and 81 controls assessed at baseline and at 1 and 2 years, respectively. Median Functional Assessment of Cancer Treatment-Fatigue scores (range, 0 to 52) for patients improved from 31 (on chemotherapy) to 43 and 45 at 1 and 2 years, respectively, but were stable in controls (46 to 48). Median Functional Assessment of Cancer Treatment-Endocrine Symptoms scores (range, 0 to 72) for patients improved from 57 (on chemotherapy) to 59 and 61 at 1 and 2 years, respectively, and were stable in controls (64 to 65). Differences between patients and controls remained significant for these scales. The incidence of moderate-severe cognitive dysfunction by the High Sensitivity Cognitive Screen decreased in patients from 16% (on chemotherapy) to 4.4% and 3.8% and in controls from 5% to 3.6% and 0% at 1 and 2 years, respectively. There were minimal differences between estrogen receptor-positive patients who started hormonal therapy (mainly tamoxifen) after chemotherapy and estrogen receptor-negative patients who did not. Differences in quality of life between patients and controls were significant only at baseline.Conclusion Fatigue, menopausal symptoms, and cognitive dysfunction are important adverse effects of chemotherapy that improve in most patients. Hormonal treatment has minimal impact on them.