蒽环联合紫杉类化疗方案对乳腺癌患者月经状态的影响

Influence of combined chemotherapy with antracycline and paclitaxel on menstruation of patients with breast cancer

目的:探讨患者年龄及不同蒽环联合紫杉类化疗方案对化疗诱导停经的影响,为临床合理用药提供依据。方法:前瞻性研究绝经前乳腺癌患者接受化疗后月经变化情况,比较不同年龄段及使用不同化疗方案的患者月经状态变化的差异。结果:144例患者,≤40岁患者化疗诱导停经和长期闭经的发生率均显著低于>40岁的患者(P<0.05),并且该组发生CIA后月经恢复率较高(P<0.05)。同时还发现>40岁患者中砝码新联合泰索蒂方案诱导长期闭经率显著高于其他三组(P=0.016)。结论:年龄是化疗诱导停经的重要因素,≤40岁患者月经受化疗影响较小,停经多为可逆性。>40岁患者使用不同的蒽环联合多西紫杉醇类化疗药物对月经状态存在显著性的影响。

Objective：To study the influence of age and chemotherapeutic drugs of breast cancer patients on chemotherapy-induced amenorrhea（CIA） and to guide the further selection of drugs for chemotherapy.Methods： We prospectively studied the CIA of premenopausal breast cancer patients and compare the difference in CIA between the patients who received different chemotherapeutics or at different age periods.Results： Total of 144 patients were followed up.The occurrence rates of CIA and LCIA were significantly higher in older women（40 years） than in young women（≤40years,P0.05）.The rate of LCIA in older women（40 years） who received combined chemotherapy of imported epirubicin（IEPI） and imported docetaxel（IT） was significantly higher than others（P=0.016）.Conclusion： Age is an important factor for the CIA.Chemotherapy has less influence on the menstruation of younger women（≤40 years） and most amenorrhea is reversible.For older women,the rate of LCIA was different in patient who received different combined chemotherapy of antracycline and docetaxel.