{"title":"锁骨上照射会诱发接受腋窝淋巴结切除术和含紫杉类药物化疗的乳腺癌患者出现淋巴水肿","authors":"Nanae Horisawa, Akiyo Yoshimura, Isao Oze, Masataka Sawaki, Masaya Hattori, Haruru Kotani, Ayumi Kataoka, Yuri Ozaki, Kazuki Nozawa, Yuka Endo, Daiki Takatsuka, Ayaka Isogai, Hiroji Iwata","doi":"10.1155/2024/3250143","DOIUrl":null,"url":null,"abstract":"<div>\n <p><i>Purpose</i>. Breast cancer-related lymphedema (LE) significantly impairs the patients’ quality of life. Axillary lymph node dissection (ALND) is a strong risk factor for LE in breast cancer surgery. In addition, postoperative administration of docetaxel (DTX) has been reported to be a risk factor for LE in patients who undergo ALND. Herein, we performed the risk of objective LE after ALND. <i>Methods</i>. Patients who visited the medical follow-up clinic between 12 November 2018 and 11 January 2019 and at least one year postoperatively were eligible for this study. The risk factors for objective LE according to taxane-containing regimen, radiation therapy, and body mass index and the effects of a taxane-containing regimen followed by supraclavicular irradiation on LE were examined. <i>Results</i>. A total of 214 patients were included in this analysis, and objective LE was observed in 52 patients (24%). Univariate and multivariate analyses showed that only supraclavicular field irradiation was a statistically significant risk factor for objective LE. In addition, the sequential use of taxane-containing regimens and supraclavicular RT was shown to be a more likely risk factor for LE than ALND alone. We also compared each taxane regimen with supraclavicular RT and found that DTX was more likely to be a risk factor for LE in cases of sequential use of supraclavicular RT than with ALND alone. However, when comparing DTX with supraclavicular RT and PTX with supraclavicular RT directly, there was no statistically significant difference in the risk of objective LE between the two groups. <i>Conclusion</i>. The risk for LE was more likely to be higher with the sequential use of taxane-containing chemotherapy and supraclavicular field irradiation. Therefore, management of LE is important in these cases.</p>\n </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3250143","citationCount":"0","resultStr":"{\"title\":\"Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy\",\"authors\":\"Nanae Horisawa, Akiyo Yoshimura, Isao Oze, Masataka Sawaki, Masaya Hattori, Haruru Kotani, Ayumi Kataoka, Yuri Ozaki, Kazuki Nozawa, Yuka Endo, Daiki Takatsuka, Ayaka Isogai, Hiroji Iwata\",\"doi\":\"10.1155/2024/3250143\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><i>Purpose</i>. Breast cancer-related lymphedema (LE) significantly impairs the patients’ quality of life. Axillary lymph node dissection (ALND) is a strong risk factor for LE in breast cancer surgery. In addition, postoperative administration of docetaxel (DTX) has been reported to be a risk factor for LE in patients who undergo ALND. Herein, we performed the risk of objective LE after ALND. <i>Methods</i>. Patients who visited the medical follow-up clinic between 12 November 2018 and 11 January 2019 and at least one year postoperatively were eligible for this study. The risk factors for objective LE according to taxane-containing regimen, radiation therapy, and body mass index and the effects of a taxane-containing regimen followed by supraclavicular irradiation on LE were examined. <i>Results</i>. A total of 214 patients were included in this analysis, and objective LE was observed in 52 patients (24%). Univariate and multivariate analyses showed that only supraclavicular field irradiation was a statistically significant risk factor for objective LE. In addition, the sequential use of taxane-containing regimens and supraclavicular RT was shown to be a more likely risk factor for LE than ALND alone. We also compared each taxane regimen with supraclavicular RT and found that DTX was more likely to be a risk factor for LE in cases of sequential use of supraclavicular RT than with ALND alone. However, when comparing DTX with supraclavicular RT and PTX with supraclavicular RT directly, there was no statistically significant difference in the risk of objective LE between the two groups. <i>Conclusion</i>. The risk for LE was more likely to be higher with the sequential use of taxane-containing chemotherapy and supraclavicular field irradiation. Therefore, management of LE is important in these cases.</p>\\n </div>\",\"PeriodicalId\":56326,\"journal\":{\"name\":\"Breast Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-07-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3250143\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Breast Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/2024/3250143\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast Journal","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/2024/3250143","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:乳腺癌相关淋巴水肿(LE)严重影响患者的生活质量。乳腺癌相关淋巴水肿(LE)严重影响患者的生活质量。在乳腺癌手术中,腋窝淋巴结清扫术(ALND)是导致淋巴水肿的一个重要危险因素。此外,有报道称术后使用多西他赛(DTX)也是导致 ALND 患者淋巴水肿的风险因素之一。在此,我们对 ALND 后客观 LE 的风险进行了研究。方法。在 2018 年 11 月 12 日至 2019 年 1 月 11 日期间到医疗随访门诊就诊且术后至少一年的患者有资格参与本研究。根据含类固醇方案、放疗和体重指数,研究客观 LE 的风险因素,以及含类固醇方案后锁骨上照射对 LE 的影响。研究结果本次分析共纳入了 214 例患者,其中 52 例患者(24%)观察到了客观 LE。单变量和多变量分析表明,只有锁骨上野外照射是导致客观 LE 的具有统计学意义的危险因素。此外,连续使用含紫杉类药物的治疗方案和锁骨上 RT 比单独使用 ALND 更有可能成为 LE 的风险因素。我们还比较了每种含紫杉类药物方案与锁骨上 RT,发现在连续使用锁骨上 RT 的病例中,DTX 比单独使用 ALND 更有可能成为 LE 的风险因素。然而,如果将 DTX 与锁骨上 RT 和 PTX 与锁骨上 RT 直接进行比较,则两组患者发生客观 LE 的风险在统计学上没有显著差异。结论。相继使用含紫杉类药物的化疗和锁骨上野外照射时,发生 LE 的风险更高。因此,对这些病例进行 LE 管理非常重要。
Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy
Purpose. Breast cancer-related lymphedema (LE) significantly impairs the patients’ quality of life. Axillary lymph node dissection (ALND) is a strong risk factor for LE in breast cancer surgery. In addition, postoperative administration of docetaxel (DTX) has been reported to be a risk factor for LE in patients who undergo ALND. Herein, we performed the risk of objective LE after ALND. Methods. Patients who visited the medical follow-up clinic between 12 November 2018 and 11 January 2019 and at least one year postoperatively were eligible for this study. The risk factors for objective LE according to taxane-containing regimen, radiation therapy, and body mass index and the effects of a taxane-containing regimen followed by supraclavicular irradiation on LE were examined. Results. A total of 214 patients were included in this analysis, and objective LE was observed in 52 patients (24%). Univariate and multivariate analyses showed that only supraclavicular field irradiation was a statistically significant risk factor for objective LE. In addition, the sequential use of taxane-containing regimens and supraclavicular RT was shown to be a more likely risk factor for LE than ALND alone. We also compared each taxane regimen with supraclavicular RT and found that DTX was more likely to be a risk factor for LE in cases of sequential use of supraclavicular RT than with ALND alone. However, when comparing DTX with supraclavicular RT and PTX with supraclavicular RT directly, there was no statistically significant difference in the risk of objective LE between the two groups. Conclusion. The risk for LE was more likely to be higher with the sequential use of taxane-containing chemotherapy and supraclavicular field irradiation. Therefore, management of LE is important in these cases.
期刊介绍:
The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include:
Risk Factors
Prevention
Early Detection
Diagnosis and Therapy
Psychological Issues
Quality of Life
Biology of Breast Cancer.