乳腺癌患者月经状态改变与化疗方案及年龄的关系

The association of menstruation of breast cancer patients with chemotherapy regimen and aging period

目的:本研究旨在探讨不同化疗方案以及患者年龄对化疗诱导停经的影响,为进一步内分泌治疗药物的选择提供依据。方法:回顾性研究绝经前乳腺癌患者接受化疗后月经变化情况,比较不同化疗方案及患者不同年龄段月经状态变化的差异。结果:在103例患者中,蒽环类与紫杉类化疗组的月经变化差异无统计学意义(P=0.719)。在不同年龄组中,大于45岁患者永久性停经者的比例明显高于45岁以下患者(P<0.001)。低龄患者发生停经要晚于高龄患者(P=0.001)。结论:年龄是化疗诱导停经的重要影响因素,小于45岁的患者月经受化疗影响较小,停经多为可逆性,则内分泌治疗不适宜直接选择芳香化酶抑制剂。紫杉类化疗药物并没有比蒽环类药物对月经影响更大。

Objective： We aimed to study the influence of chemotherapeutic regimens and aging of breast cancer patients on chemotherapy-induced amenorrhea （CIA） and to guide the further selection of drugs for endocrine therapy. Methods： We retrospectively studied the chemotherapy-induced amenorrhea （CIA） of the premenopausal breast cancer patients and compare the difference in CIA between the patients who received different chemotherapies or at different aging periods. Results： One hundred and three women were followed up. The difference in the rate of CIA was not statistically significant between the women who received anthracycline-based chemotherapy and docetaxel-based chemotherapy （70.6% vs 61.1%, P =0. 719）. The occurrence rate of CIA was significantly higher in older women （ 〉45 years） than young women （ ≤45 years,P 〈0.1301 ）. CIA occurred more lately in young women than old women （P =0.001 ）. Conclusion：Age is an important factor for the CIA. Chemotherapy has less influence on the menstruation of younger women （ ≤45 years） and most amenorrhea is reversible. For these patients aromatase inhibitors are not recommended for adjuvant endocrine therapy. The effect of docetaxel on menstruation is not greater than anthracycline.