A prospective assessment of musculoskeletal toxicity and loss of grip strength in breast cancer patients receiving adjuvant aromatase inhibitors and tamoxifen, and relation with BMI
| Autor: | Ann Smeets, M-R Christiaens, Dirk Vanderschueren, Caroline Weltens, Annouschka Laenen, Robert Paridaens, Anneleen Lintermans, E. Van Limbergen, Patrick Neven, Hans Wildiers, K. Van Asten, Johan Verhaeghe, Karin Leunen |
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| Rok vydání: | 2014 |
| Předmět: |
Cancer Research
medicine.medical_specialty Antineoplastic Agents Hormonal medicine.drug_class Breast Neoplasms Body Mass Index Medication Adherence Grip strength Breast cancer Musculoskeletal Pain Risk Factors Hand strength Internal medicine Surveys and Questionnaires Medicine Humans Musculoskeletal Diseases Prospective Studies Neoplasm Metastasis Prospective cohort study Aged Neoplasm Staging Aged 80 and over Aromatase inhibitor Hand Strength business.industry Aromatase Inhibitors Chemoradiotherapy Adjuvant Middle Aged medicine.disease Discontinuation Postmenopause Tamoxifen Oncology Physical therapy Female Neoplasm Grading business Body mass index medicine.drug |
| Zdroj: | Breast cancer research and treatment. 146(1) |
| ISSN: | 1573-7217 |
| Popis: | Aromatase inhibitor (AI) therapy for estrogen receptor-positive breast cancer is known to induce or enhance musculoskeletal problems. We have previously reported that loss of grip strength is more pronounced in AI-users with extremes in BMI. We here report results from a larger prospective study. Postmenopausal early breast cancer patients scheduled to start AI or tamoxifen therapy were recruited. A functional assessment grip strength test was performed at baseline, 3, 6, and 12 months of therapy. BMI was assessed, and a rheumatologic questionnaire was completed at each visit. 188 patients on an AI and 104 patients on tamoxifen were enrolled. 74 % of AI-users reported new/worsened musculoskeletal complaints compared with 37 % in the tamoxifen group. This was translated in a larger grip strength decrease in patients experiencing AI-induced pain opposed to patients without new/worsened complaints (p = 0.0002). 15 % of AI-users discontinued therapy due to musculoskeletal symptoms, who were characterized by a larger grip strength reduction versus adherent patients (p = 0.0107). Young age (p = 0.0135), taxane-based chemotherapy (p = 0.0223), and baseline VAS score >4 (p = 0.0155) were predictors for AI-related musculoskeletal pain. In addition, a quadratic trend of BMI with grip strength change (p = 0.0090) and probability of discontinuation was observed (p = 0.0424). Musculoskeletal events were a substantial problem in AI-treated patients and an important reason for treatment discontinuation. The decrease in grip strength was larger in AI- than in tamoxifen-users, with a more pronounced change in symptomatic patients. The inverse relationship between BMI extremes and grip strength change was confirmed in this large group of AI-patients. |
| Databáze: | OpenAIRE |
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