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在更年期前后妇女的认知障碍和化学内分泌与内分泌疗法:RxPONDER随机临床试验的二次分析
Irene M Kang1, Jamie K Forschmiedt2, Michelle M Loch3
1City of Hope Comprehensive Cancer Center, Irvine, California.
JAMA oncology
|December 11, 2025
概括
化疗加上内分泌疗法 (CET) 对乳腺癌患者的认知功能产生负面影响,比单独的内分泌疗法 (ET) 更大. 这种效应在36个月内在绝经前和绝经后的妇女中观察到.
科学领域:
- 在瘤学瘤学.
- 神经科学是一个神经科学.
- 临床试验 临床试验
背景情况:
- 乳腺癌治疗,包括内分泌疗法 (ET) 和化疗加内分泌疗法 (CET),与与癌症相关的认知障碍 (CRCI) 有关.
- 对ET与CET对CRCI的比较影响,特别是考虑到更年期状态,仍然不太清楚.
研究的目的:
- 为了比较患者报告的乳腺癌患者单独接受ET治疗与CET治疗之间的CRCI.
- 调查接受这些治疗的患者更年期状态和CRCI之间的关联.
主要方法:
- 对涉及5000多名女性的跨国第三期RxPONDER试验 (SWOG S1007) 的二次分析.
- 随机分配到CET或ET的激素受体阳性,ERBB2-阴性乳腺癌患者与1-3阳性淋巴结和低的瘤型DX分数.
- 认知功能使用患者报告结果测量信息系统的认知功能担忧 (PCF) 问卷在基线,6,12和36个月时进行评估.
主要成果:
- 与单独使用ET相比,CET与患者报告的CRCI在36个月内在绝经前和绝经后的参与者中显示出更大的负相关性.
- 接受单独ET的绝经前参与者显示暂时PCF得分下降,恢复36个月,而绝经后参与者的得分保持稳定.
- 接受CET的绝经前和绝经后的参与者都经历了与基线相比显著的PCF得分下降,在36个月后没有恢复到基线水平.
结论:
- 化疗加上内分泌疗法 (CET) 与单独的内分泌疗法 (ET) 相比,对患者报告的认知功能产生更明显的负面影响.
- 这些发现强调了需要采取干预措施来缓解CRCI,并改善经过CET的乳腺癌患者的长期生活质量.
- 这项研究强调了考虑治疗模式在乳腺癌存活率认知副作用的背景下的重要性.
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