绝经前乳腺癌患者化疗致闭经的发生率及其影响因素分析

Analysis of incidence and influencing factors of chemotherapy-induced amenorrhea in patients with premenopausal breast cancer

目的:探讨绝经前乳腺癌患者化疗致闭经(CIA)的影响因素。方法:收集2016至2018年的305例行辅助化疗的绝经前乳腺癌患者,随访其化疗后月经变化情况,分析CIA发生的影响因素。结果:CIA发生率为69.51%(212/305),其中月经恢复率为44.8%(95/212)。年龄与CIA发生率、月经恢复情况均显著相关(P<0.05)。年轻的患者表现出更低的CIA发生率和更高的月经恢复率。但孕产次、腋窝淋巴结转移与否、雌激素受体(ER)、孕激素受(PR)、HER-2状况、病理分期等因素与CIA发生率均无显著相关性(P>0.05)。行AC-T和TAC/AT化疗方案的患者CIA发生率高于行TC方案的患者(P<0.05)。用他莫昔芬内分泌治疗的患者CIA发生率为72.63%,略高于未使用者,但无统计学差异(P>0.05)。结论:年龄显著影响绝经前乳腺癌患者的CIA发生率,且随着年龄的增大,CIA发生几率增加,月经恢复几率减少。此外,蒽环类与紫杉类药物联合或序贯使用可导致CIA发生率较高。

Objective:To explore the influencing factors of chemotherapy-induced amenorrhea(CIA)in premenopausal breast cancer patients.Methods:A total of 305 premenopausal breast cancer patients treated with adjuvant chemotherapy from 2016 to 2018 were collected.The changes of menstruation after chemotherapy were traced and the influencing factors of CIA were analyzed.Results:The incidence of CIA was 69.51%(212/305)and the recovery rate of menstruation was 44.8%(95/212).The age was significantly related to the incidence of CIA and menstrual recovery(P<0.05).Younger patients showed a lower incidence of CIA and a higher rate of menstrual recovery.However,the factors such as the time of pregnancy,axillary lymph node metastasis,estrogen receptor(ER),progesterone receptor(PR),HER-2 status and pathological stage were not correlated with the incidence of CIA(P>0.05).The incidence of CIA was significantly higher in AC-T and TAC/AT than that in TC regimens(P<0.05).The incidence of CIA was 72.63%in patients receiving tamoxifen endocrine therapy,which was slightly higher than that in non-users,but without significant difference(P>0.05).Conclusion:The age significantly affected the incidence of CIA in premenopausal breast cancer patients.As the age increased,the incidence of CIA increased and the probability of menstrual recovery decreased.Besides,combined or sequential use of anthracyclines and taxanes displayed a high incidence of CIA.