预测化疗后服用他莫昔芬的绝经前乳腺癌妇女的月经恢复模式:ASTRRA 子研究。

IF 7.4 1区 医学 Q1 Medicine
Young Joo Lee, Woo Chul Noh, Sungchan Gwark, Hyun-Ah Kim, Jai Min Ryu, Seung Il Kim, Eun-Gyeong Lee, Seock-Ah Im, Yongsik Jung, Min Ho Park, Kyong Hwa Park, Su Hwan Kang, Joon Jeong, Eunhwa Park, Sung Yong Kim, Min Hyuk Lee, Lee Su Kim, Woosung Lim, Seonok Kim, Hee Jeong Kim
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引用次数: 0

摘要

背景:化学内分泌治疗可导致与卵巢功能障碍相关的各种副作用。预测月经恢复情况是与患者讨论生育和过早绝经等治疗相关问题的必要条件:在 ASTRRA 试验中,化疗后 2 年内恢复卵巢功能的患者被随机分配接受他莫昔芬治疗 5 年或他莫昔芬联合 OFS 治疗 2 年。通过这 1298 名患者,我们建立了一个模型,利用年龄、体重指数、化疗方案和持续时间、血清雌二醇和卵泡刺激素水平等变量预测化疗后 3 年内月经恢复的时间:957名患者的数据用于建立预测模型,341名患者的数据用于验证。在开发组中,450 名患者(47.0%)在 5 年内恢复了月经。在多变量分析中,较小的年龄(90 天,HR 1.32,95% CI 1.01-1.72,p = 0.045)与月经恢复相关。综合年龄、治疗方案和化疗持续时间,我们建立了一个简化的评分系统来估算月经恢复的几率,并使用0.679的总体一致性指数和0.744的3年一致性指数进行验证:该模型根据绝经前乳腺癌患者的年龄、化疗类型和化疗持续时间,预测了化疗后接受他莫昔芬治疗的绝经前妇女月经恢复的时间和概率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prediction of menstrual recovery patterns in premenopausal women with breast cancer taking tamoxifen after chemotherapy: an ASTRRA Substudy.

Background: Chemo-endocrine therapy can lead to various side effects associated with ovarian dysfunction. Predicting menstrual recovery is necessary to discuss the treatment-related issues regarding fertility and premature menopause with patients.

Methods: In the ASTRRA trial, patients who resumed ovarian function within 2 years after chemotherapy were randomized to receive tamoxifen for 5 years or OFS with tamoxifen for 2 years. With these 1298 patients, we developed a model that predicts when menstrual recovery will occur within a 3-year period after chemotherapy using variables including age, body mass index, chemotherapy regimen and duration, and serum estradiol and follicle-stimulating hormone levels.

Results: The data of 957 patients were used to develop the prediction model, and those of 341 patients were used for validation. In the development group, menstruation resumed in 450 patients (47.0%) within 5 years. In multivariable analysis, younger age (< 35 vs. 45, HR 7.85, 95% CI 4.63-13.30, p < 0.0001), anthracycline-based chemotherapy without taxane (vs. with taxane, HR 1.81, 95% CI 1.37-2.38, p < 0.0001), and chemotherapy duration (≤ 90 days vs. > 90 days, HR 1.32, 95% CI 1.01-1.72, p = 0.045) correlated with menstrual recovery. Using combined age, regimen, and duration of chemotherapy, we developed a simplified scoring system to estimate recovery chances and used a concordance index of 0.679 overall and 0.744 at 3 years for validation.

Conclusion: This model predicted timing and probability of menstrual recovery, based on their individual age, type and duration of chemotherapy in premenopausal women diagnosed with breast cancer who received tamoxifen after chemotherapy.

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来源期刊
CiteScore
12.00
自引率
0.00%
发文量
76
审稿时长
12 weeks
期刊介绍: Breast Cancer Research, an international, peer-reviewed online journal, publishes original research, reviews, editorials, and reports. It features open-access research articles of exceptional interest across all areas of biology and medicine relevant to breast cancer. This includes normal mammary gland biology, with a special emphasis on the genetic, biochemical, and cellular basis of breast cancer. In addition to basic research, the journal covers preclinical, translational, and clinical studies with a biological basis, including Phase I and Phase II trials.
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