乳腺癌患者化疗期间味觉改变趋势及影响因素分析

Trends and influencing factor of chemotherapy-induced taste alteration in breast cancer patients

目的描述乳腺癌患者化疗相关性味觉改变的变化规律,分析其影响因素,为制定针对性干预措施提供参考。方法采用前瞻性纵向研究设计,在北京市某三甲医院乳腺中心招募90例乳腺癌化疗患者,分别于化疗前、第2次化疗前、末次化疗前对患者进行测评,采用中文版化疗相关味觉改变量表测评患者的味觉改变情况。采用广义估计方程分析各测评时间点化疗相关味觉改变情况及其影响因素。结果最终共89例患者纳入最终分析,平均年龄为(53.5±9.4)岁,26例(29.21%)患者接受新辅助化疗,63例(70.79%)患者接受辅助化疗。乳腺癌患者首次化疗前、第2次化疗前、末次化疗前的化疗相关味觉改变总分分别为(18.69±1.59)、(22.53±4.24)、(25.14±5.68)分;广义估计方程分析发现,化疗相关味觉改变总分、整体性味觉均分、基本味觉均分随着化疗进行逐渐加重(P<0.01);味觉异常均分、不适症状均分在首次化疗后即明显改变(P<0.01),化疗期间不再明显加重(P>0.05)。化疗相关味觉改变总分与年龄、化疗方案密切相关。结论乳腺癌患者在化疗期间经受着逐渐加重的味觉变化,年龄、化疗方案是化疗相关味觉改变的影响因素。提示应重视味觉改变的健康宣教和干预,以减轻乳腺癌化疗患者的味觉改变情况。

Objective To investigate the changing trends and influencing factors of chemotherapy induced taste alteration in breast cancer patients,in order to provide a reference for the formulation of targeted intervention measures.Methods A prospective longitudinal design was used to recruit 90 breast cancer patients undergoing chemotherapy at a tertiary hospital in Beijing.Assessments were performed before the first cycle,before the second cycle,and before the last cycle with the chemotherapy-induced taste alteration scale.Generalized estimating equations were used to analyze the changing trends of taste alteration during chemotherapy,and the influencing factors of taste alteration.Results Eighty-nine patients were included in this study,with an average age of(53.5±9.4)years,of whom 26(29.21%)underwent neoadjuvant chemotherapy and 63(70.79%)underwent adjuvant chemotherapy.The scores of taster alteration were(18.69±1.59),(22.53±4.24),and(25.14±5.68)before the first cycle,before the second cycle,and before the last cycle,respectively.Results of generalized estimating equations showed that the taster alteration score,general taste alteration score,and basic taste score were getting worse with the prolongation of chemotherapy(P<0.01).The scores of phantogeusia,parageusia,and discomfort were significantly increased after the first cycle(P<0.01),but there was no obvious increase during chemotherapy(P>0.05).Age and chemotherapy regimen were related to the taste alteration score.Conclusion Breast cancer patients experience gradually worsening taste changes during chemotherapy,and age and chemotherapy regimen are the influencing factors of taste changes related to chemotherapy.It is suggested that more attention be paid to the health education and intervention of taste change,in order to reduce the taste change in breast cancer patients undergoing chemotherapy.