Weak circadian rhythm increases neutropenia risk among breast cancer patients undergoing adjuvant chemotherapy
Publication in refereed journal

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其它資訊
摘要Purpose:
Severe neutropenia is a common dose-limiting side effect of adjuvant breast cancer chemotherapy. We aimed to test the hypothesis that weak circadian rhythm is associated with an increased risk of neutropenia using a cohort study.
Methods:
We consecutively recruited 193 breast cancer patients who received adjuvant chemotherapy (5-fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel; doxorubicin and cyclophosphamide; docetaxel and cyclophosphamide). Participants wore a wrist actigraph continuously for 168 h at the beginning of chemotherapy. Values of percent rhythm and double amplitude below medians represented weak circadian rhythm. Mesor measured the mean activity level and acrophase symboled the peak time of the rhythm. We used Cox proportional hazard regression model to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of grade 4 neutropenia and febrile neutropenia in relation to actigraphy-derived parameters.
Results:
Low levels of percent rhythm (HR:2.59, 95% CI 1.50–4.72), double amplitude (HR:2.70, 95% CI 1.51–4.85), and mesor (HR: 2.48, 95% CI 1.44–4.29) were positively associated with the risk of grade 4 neutropenia during chemotherapy. Low levels of percent rhythm (HR: 2.41, 95% CI 1.02–5.69) and double amplitude (HR:2.49, 95% CI 1.05–5.90) were also associated with increased risks of febrile neutropenia. The HRs for acrophase were not statistically significant.
Conclusions:
This study provides the first epidemiological evidence that increased risks of grade 4 neutropenia and febrile neutropenia are associated with weak circadian rhythm among adjuvant breast cancer patients. The results suggest that circadian rhythm might be one potential target for the prevention of chemotherapy-induced neutropenia among cancer patients.
出版社接受日期10.11.2017
著者Wentao Li, Carol Chi-Hei Kwok, Dominic Chun-Wan Chan, Feng Wang, Lap Ah Tse
期刊名稱Breast Cancer Research and Treatment
出版年份2018
月份4
卷號168
期次2
頁次483 - 493
國際標準期刊號0167-6806
電子國際標準期刊號1573-7217
語言英式英語
關鍵詞Breast cancer, Chemotherapy, Circadian rhythm, Neutropenia, Myelosuppression

上次更新時間 2020-23-11 於 01:45