关键词: 乳腺癌, 骨髓抑制, 化疗

Abstract: Objective To observe and analyze the related relationship of myelosuppression after chemotherapy for breast cancer. Methods A total of 120 breast cancer patients from the Breast Department of Guangdong Maternal and Child Health Hospital and the Oncology Department of Shaoyang Central Hospital from January 2022 to June 2023 were collected. The patients were divided into non-myelosuppression group （control group, n=20）, mild myelosuppression group （mild group, n=76）, and severe myelosuppression group （severe group, n=24） according to the situation of postoperative chemotherapy myelosuppression. The postoperative chemotherapy regimens for all patients were EC→T, AC or EC. The collected and preliminary analyzed data included the clinical characteristics of 120 patients, the univariate analysis of myelosuppression after chemotherapy in the three groups of patients, the relationship between postoperative chemotherapy myelosuppression and various adverse reactions, and the relationship between the degree of myelosuppression and the severity of adverse reactions. Results Among the 120 patients who underwent postoperative chemotherapy for breast cancer, 83.3% （100 cases） experienced varying degrees of myelosuppression, among which 76.0% （76 cases） were mild cases （grades Ⅰ and Ⅱ）, 20% （24 cases） were severe cases （grades Ⅲ and Ⅳ）, and 16.7% （20 cases） of the patients did not experience myelosuppression. No patient interrupted or reduced the dose of chemotherapy. The degree of myelosuppression was related to the patient′s age, chemotherapy regimen, nutritional status, and pre-chemotherapy combined with diabetes, and there were statistical significances between the patients in the control group, the mild myelotransplant group, and the severe myelosuppression group （all Ps were less than 0.05）. Among the seven adverse reaction symptoms counted, there was no statistical significance among the patients in the control group, the mild group, and the severe group （all Ps were more than 0.05）. According to the WHO adverse reaction classification standard, the distribution of adverse reaction grades after chemotherapy in patients with different degrees of myelosuppression was different. The more severe the degree of myelosuppression, the higher the grade of adverse reactions （P=0.001）. Conclusion Chemotherapy-induced myelosuppression was associated with patient age, chemotherapy regimen, nutritional status, and pre-chemotherapy comorbid diabetes mellitus; the proportion of chemotherapeutic toxicities occurring may not be related to the degree of myelosuppression, but was associated with the WHO grading of adverse effects.

Key words: breast cancer, myelosuppression, chemotherapy