Risk of subsequent dementia diagnoses does not vary by types of adjuvant chemotherapy in older women with breast cancer.
Risk of subsequent dementia diagnoses does not vary by types of adjuvant chemotherapy in older women with breast cancer.
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DOI：
10.1007/s12032-008-9145-0
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发表时间：
2009-12
期刊：
影响因子：
--
通讯作者：
Goodwin JS
中科院分区：
文献类型：
--
作者：
Raji MA;Tamborello LP;Kuo YF;Ju H;Freeman JL;Zhang DD;Giordano SH;Goodwin JS
对于乳腺癌辅助化疗的长期认知副作用知之甚少。因此，我们检查了诊断为乳腺癌的老年女性的痴呆症诊断发生率，并按化疗方案类型进行分层。我们通过与国家癌症研究所的监测、流行病学和最终结果 (SEER) 肿瘤登记数据相关的医疗保险索赔来确定患有痴呆症诊断的患者。研究人群 (n = 6,932) 由至少 68 岁的女性组成，她们从 1994 年到 2002 年在 SEER 地区之一被诊断患有早期乳腺癌，并接受化疗作为癌症治疗的一部分。排除在癌症诊断前 3 年内诊断出痴呆症的女性。我们的样本主要由白人女性组成。平均年龄为 74 岁。百分之五十七的人雌激素受体呈阳性。超过 70% 的人没有合并症。从 20 世纪 90 年代中期到 2000 年初，紫杉醇和蒽环类药物的使用有所增加。癌症诊断年龄的增加、黑人种族、生活在教育水平较低的人口普查区以及合并症数量的增加与化疗后新诊断出痴呆症的说法相关。化疗药物的类型与随后痴呆诊断的风险之间没有显着关联。未发现乳腺癌辅助化疗药物类型与新诊断痴呆的风险之间存在关联。我们的研究结果表明，对化疗后痴呆的担忧不应成为确定老年乳腺癌女性辅助化疗方案类型的主要因素。
Little is known about long-term cognitive side effects of adjuvant chemotherapy for breast cancer. We thus examined incidence of dementia diagnoses in older women diagnosed with breast cancer, stratified by types of chemotherapy regimen. We identified patients with incident dementia diagnoses through Medicare claims linked to the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) tumor registry data. The study population (n = 6,932) consisted of women at least 68 years of age, who were diagnosed with early-stage breast cancer from 1994 through 2002 in one of the SEER areas and received chemotherapy as part of their cancer treatment. Excluded were women with a diagnosis of dementia within the 3 years prior to their cancer diagnosis. Our sample comprised mostly white women. The mean age was 74. Fifty-seven percent were estrogen receptor positive. Over 70% had no comorbidity. The use of taxol and anthracycline-based treatments increased from mid-1990s to early 2000. Increasing age at cancer diagnosis, Black ethnicity, living in a census tract with lower level of education, and increasing number of comorbidities were associated with new claims of dementia diagnoses after chemotherapy. There was no significant association between types of chemotherapy agents and risk of subsequent dementia diagnoses. No association was found between types of adjuvant chemotherapy agents for breast cancer and risk of new dementia diagnoses. Our findings suggest that concerns about post-chemotherapy dementia should not be a major factor in determining type of adjuvant chemotherapy regimen to prescribe for older women with breast cancer.
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