蒽环类药物对乳腺癌患者月经状态的影响  

Influence of anthracycline-based chemotherapy on menstruation of patients with breast cancer

作　　者：李永峰[1] 吴云飞[1] 

机构地区：[1]中国医科大学附属第一医院乳腺外科,沈阳110001

出　　处：《肿瘤研究与临床》2011年第7期453-455,共3页Cancer Research and Clinic

摘　　要：目的研究乳腺癌患者年龄及不同蒽环类化疗药物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药物的患者月经状态变化的差异。结果137例乳腺癌患者，化疗致闭经（CIA）的发生率为73．72％（101／137），长期闭经（LCIA）发生率为43．80％（60／137）。40岁以下患者CIA和LCIA的发生率均显著低于40岁以上的患者（X^2=25．32、18．42，P〈0．05），并且40岁以下组发生CIA后月经恢复率为61．90％（13／21），明显高于40岁以上组的35．00％（28／80），差异有统计学意义（X^2=4．99，P=0．025）。40岁以上患者中表柔比星（商品名：法玛新）、表柔比星（商品名：艾达生）、吡柔比星诱导LCIA率差异有统计学意义（X^2=6．92，P=0．031）。结论年龄是CIA的重要因素，40岁以下患者月经受化疗影响较小，停经多为可逆性。40岁以上患者使用不同的蒽环类化疗药物对月经状态的影响差异有统计学意义。Objective To study the influence of aging 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 the premenopausal breast cancer patients and compared the difference in CIA between the patients who were at different aging periods or received different ehemotherapeuties. Results 137 patients were followed up. The occurrence rate of CIA and long-term chemotherapy-induced amenorrhea（LCIA） were 73.72 % （101/137） and 43.80 % （60/137） respectively. The rate of CIA and LCIA was significantly higher in older women （〉40 years） than young women （≤40 years, X^2 =25.32, 18.42, P 〈0.05）. The recovery rate of CIA in young women was 61.90 % （13/21） which was significantly higher than the older women [35.00 % （28/80）; X^2 =4.99, P =0.025]. The difference in the rate of LC1A was statistically significant between the older women （〉40 years） who received different anthracycline-based chemotherapy （X^2 =6.92, P =0.031）. Conclusion Age is an important factor for the CIA. Chemotherapy has less influence on the menstruation of younger women（≤40） and most amenorrhea is reversible. For older women,the rate of LCIA is different in patients who receive imported epirubicin, domestic epirubicin or pirarubicin.

关 键 词：乳腺癌 辅助化疗 蒽环类药 闭经 

分 类 号：R737.9[医药卫生—肿瘤]