常用处方药物与患乳腺癌相关淋巴水肿风险的回顾性分析

Clinical research and trials Pub Date : 2020-02-01 Epub Date: 2020-02-28 DOI:10.15761/crt.1000293
Eelco Fj Meijer, Echoe M Bouta, Clive Mendonca, Melissa N Skolny, Laura W Salama, Alphonse G Taghian, Timothy P Padera
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引用次数: 5

摘要

目的:乳腺癌相关淋巴水肿(BCRL)是当前乳腺癌治疗方式的常见并发症,显著降低了这些患者的生活质量,并经常导致复发性感染。在此,基于临床前文献,我们旨在回顾性评估处方药对BCRL发展的风险。方法:选取2005-2013年在马萨诸塞州总医院接受放疗并发生淋巴水肿的乳腺癌术后患者(115例)。随机选取无淋巴水肿的患者230例作为对照。分析了以下几类药物:非甾体抗炎药、皮质类固醇、血管紧张素系统抑制剂、钙通道阻滞剂和激素治疗。已知的淋巴水肿发展的危险因素包括BMI、诊断时的年龄、手术类型、切除的淋巴结数量和放射治疗。结果是BCRL的发展和淋巴水肿的严重程度。结果:与之前的研究类似,我们发现BMI增加会增加BCRL的风险(p=0.006),与前哨淋巴结活检相比,腋窝淋巴结清扫发生BCRL的风险更高(p=0.045)。所研究的药物均未增加BCRL发展或淋巴水肿严重程度的风险。然而,淋巴水肿严重程度与淋巴结切除数呈正相关(p=0.034)。结论:我们发现乳腺癌患者术后一年内服用抗炎药、降压药和激素治疗不会增加BCRL发生或淋巴水肿严重程度的风险。虽然其他人已经证明手术中切除的淋巴结数量会增加BCRL的风险,但我们发现它也与淋巴水肿的严重程度有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A retrospective analysis of commonly prescribed medications and the risk of developing breast cancer related lymphedema.

A retrospective analysis of commonly prescribed medications and the risk of developing breast cancer related lymphedema.

Objectives: Breast cancer related lymphedema (BCRL) is a common complication of current breast cancer treatment modalities, significantly lowering quality of life for these patients and often leading to recurrent infections. Here, based on pre-clinical literature, we aim to retrospectively evaluate the risks of prescribed medications on BCRL development.

Methods: All post-operative breast cancer patients who received radiotherapy from 2005-2013 at Massachusetts General Hospital and developed lymphedema(n=115) were included in the analysis. Comparable patients without lymphedema(n=230) were randomly selected as control. The following classes of medications were analyzed: NSAIDs, corticosteroids, angiotensin system inhibitors, calcium channel blockers and hormonal therapy. Known risk factors for lymphedema development were included as variables, including BMI, age at diagnosis, type of surgery, number of lymph nodes removed and radiation therapy. Outcomes were BCRL development and lymphedema severity.

Results: Similarly, to previous studies, we found that an increase in BMI increases the risk of BCRL(p=0.006) and axillary lymph node dissection has a higher risk of developing BCRL compared to sentinel lymph node biopsy(p=0.045). None of the drugs studied increased the risk of BCRL development or lymphedema severity. However, lymphedema severity was positively correlated with the number of lymph nodes removed(p=0.034).

Conclusion: We found that anti-inflammatory drugs, anti-hypertensive drugs and hormonal therapy taken during the year postoperatively do not increase the risk of BCRL development or lymphedema severity in breast cancer patients. While others have demonstrated that the number of lymph nodes removed during surgery increases the risk of BCRL, we found it also correlates to lymphedema severity.

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