基于内分泌治疗和年龄的乳腺癌患者的骨折风险差异:一项全国性队列研究
Mi Kyung Kwak1, Seeyoun Lee2, Jin-Young Lee3
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
概括
50岁以下使用芳酶抑制剂 (AI) 的乳腺癌幸存者显示骨折风险增加,而50岁以上的他莫西芬使用者则减少了骨折风险. 与非使用者相比,接受AI的绝经后妇女没有增加骨折风险.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 流行病学 流行病学
背景情况:
- 乳腺癌存活率的上升增加了对骨质疏松症和内分泌治疗骨折的担忧.
- 评估与不同内分泌疗法相关的骨折风险对于患者管理至关重要.
研究的目的:
- 为了比较塔莫西芬使用者,芳香酶抑制剂 (AI) 使用者和非使用者之间的骨折发病率.
- 分析接受内分泌治疗的绝经前和绝经后乳腺癌患者的骨折风险.
主要方法:
- 一项回顾性队列研究,利用来自韩国中央癌症登记处和国家健康保险服务的数据.
- 对63,021名新诊断乳腺癌患者 (2008-2016) 的分析.
- 基于手术后内分泌治疗评估骨折风险的多变量Cox比例危险模型.
主要成果:
- 69.1%的患者接受了内分泌治疗.
- 每1000个人年中骨折发病率为7.4整体,3.5 (50岁以下) 和12.6 (50岁以上).
- 50岁以上的塔莫西芬使用者有骨折风险降低 (HR=0.75);50岁以下的AI使用者有骨折风险增加 (HR=1.54).
结论:
- 人工智能使用与绝经后妇女 (50岁以上) 的骨折风险增加无关.
- 塔莫西芬的使用与50岁以上患者的骨折风险降低有关,但在50岁以下的患者中并非如此.
- 长期后续研究是有必要的,特别是考虑到韩国乳腺癌诊断的年龄很小.
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