乳腺癌患者在接受手術或化療后，常被要求繼續(xù)服用名為“它莫西芬”的藥物以防復發(fā),。但由于這種藥有副作用,，許多患者往往不按醫(yī)囑，擅自停藥,。英國一項新研究顯示,，停藥將增大患者癌癥復發(fā)和死亡的風險。
英國蘇格蘭格拉斯哥大學研究人員在《英國癌癥期刊》上報告說,，他們對1263名乳腺癌患者的處方記錄和服藥情況進行了跟蹤調(diào)查，發(fā)現(xiàn)一些患者因為出現(xiàn)潮熱,、關節(jié)痛,、疲憊或體重增加等副作用，沒有按醫(yī)生要求堅持服用它莫西芬,。
研究人員將按期服藥率不足80％的患者認定為“對堅持治療配合度低”,，并分析了她們的癌癥復發(fā)風險,。研究顯示，未堅持服藥的人群癌癥復發(fā)和死亡風險都更高,，而且因住院治療或服用其他藥物,，她們需要負擔人均近6000英鎊的額外支出,。
研究人員說，英國每年約有1．3萬名乳腺癌患者被醫(yī)生要求連續(xù)5年服用它莫西芬,，但許多患者因副作用擅自停藥,，由此造成的不必要死亡病例估計每年超過430例,，額外支出高達數(shù)百萬英鎊,。
英國“乳腺癌運動”組織首席執(zhí)行官摩根說,，它莫西芬藥效顯著,，但可能在部分人群中引發(fā)副作用。這項研究一方面提醒患者,，應堅持按醫(yī)囑服藥,；另一方面也告誡醫(yī)生,，應幫助患者堅持服藥,，并盡量克服可能出現(xiàn)的副作用。（生物谷Bioon.com）
生物谷推薦的英文摘要
British Journal of Cancer doi:10.1038/bjc.2013.116
Cohort study of adherence to adjuvant endocrine therapy,， breast cancer recurrence and mortality
B Makubate1,， P T Donnan2， J A Dewar3,， A M Thompson3 and C McCowan4
Background：
Adjuvant endocrine therapy is recommended for women with oestrogen receptor-positive breast cancer,， but many women do not take the medication as directed and they stop treatment before completing the standard 5-year duration.
Methods：
This retrospective cohort study conducted between 1993 and 2008 of all women with incident breast cancer， who are residing in the Tayside region of Scotland,， examined adherence to prescribed adjuvant tamoxifen or aromatase inhibitors (AIs). Survival analysis examined the effect of adherence on all-cause mortality,， breast cancer death and recurrence， using linked prescribing,， cancer registry,， clinical cancer audit， hospital discharge and death records.
Results：
A total of 3361 women with breast cancer were followed for a median 4.47 years (interquartile range (IQR)=2.04–8.55). The median overall adherence was 90% (IQR=90–100%),， but the annual adherence reduced after a longer period from diagnosis. Low adherence of <80% was associated with poorer survival (hazard ratios=1.20,； 95% confidence interval=1.03–1.40， P=0.019). There was no significant difference for low adherence over the treatment period and recurrence,， or breast cancer death,， but patients with high annual adherence for 5 years had better outcomes than those with 3 or less.
Conclusion：
Low adherence to all adjuvant endocrine therapy for women with breast cancer,， whether tamoxifen or AI， increases the risk of death.
