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在一项随机对照试验中,使用含紫杉烷类方案辅助化疗治疗乳腺癌时对水肿的主观和客观评估:国家外科辅助乳腺和肠研究 02 期。

Subjective and objective assessment of edema during adjuvant chemotherapy for breast cancer using taxane-containing regimens in a randomized controlled trial: The National Surgical Adjuvant Study of Breast Cancer 02.

机构信息

Department of Breast Oncology, NHO Shikoku Cancer Center, Matsuyama, Japan.

出版信息

Oncology. 2012;82(3):131-8. doi: 10.1159/000336480. Epub 2012 Mar 15.

Abstract

OBJECTIVE

To elucidate the time course of taxane-induced edema which may affect the patients' quality of life (QOL).

PATIENTS AND METHODS

Our study included the first 300 Japanese patients assigned to 1 of 4 regimens using docetaxel (DTX) or paclitaxel (PTX) by 1:1:1:1 in a randomized controlled trial to evaluate the efficacy of adjuvant therapies for node-positive breast cancer. Patients' QOL was prospectively assessed by the functional assessment of cancer therapy (FACT)-breast and -taxane (FACT-T) subscale. The scores of FACT items regarding edema and body weight were used as indicators of edema.

RESULTS

The scores for 'anasarca', 'edema of the hands' and 'edema of the legs and feet' of the FACT-T subscale worsened up to 1-2 months after chemotherapy, and body weights increased remarkably until cycle 8 in patients treated with DTX alone (75 mg/m(2), 8 cycles, every 3 weeks). Edema-related symptoms and body weight were relatively stable in the other treatment groups. There were statistically significant differences in the scores of those items and in the changes of body weight both between the DTX-alone group and the other three groups combined, and between the groups using DTX and those using PTX.

CONCLUSION

Many patients receiving DTX for >4 cycles suffered significantly from edema.

摘要

目的

阐明紫杉烷类药物引起的水肿的时间过程,这可能会影响患者的生活质量(QOL)。

患者和方法

我们的研究纳入了 300 名日本患者,他们在一项随机对照试验中按 1:1:1:1 的比例被分配至接受多西紫杉醇(DTX)或紫杉醇(PTX)的 4 种方案之一,以评估辅助治疗淋巴结阳性乳腺癌的疗效。通过功能性评估癌症治疗(FACT)-乳房和-紫杉烷(FACT-T)子量表前瞻性评估患者的 QOL。FACT 项目中关于水肿和体重的评分被用作水肿的指标。

结果

在单独使用 DTX(75mg/m(2),8 个周期,每 3 周)的患者中,FACT-T 子量表中“全身水肿”、“手部水肿”和“下肢和足部水肿”的评分在化疗后 1-2 个月内恶化,体重在第 8 个周期时显著增加。在其他治疗组中,水肿相关症状和体重相对稳定。这些项目的评分以及体重变化在 DTX 单独组与其他三组联合组之间,以及在使用 DTX 组与使用 PTX 组之间均存在统计学差异。

结论

许多接受 DTX 治疗>4 个周期的患者都出现明显的水肿。

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