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体育运动较多、体重指数较低，对乳腺癌患者的生存有益。不过，这些因素与病理完全缓解、完成化疗之间的相关性尚不明确。 2019年5月22日，日本乳腺癌学会《乳腺癌》在线发表美国耶鲁大学医学院、耶鲁公共卫生学院、耶鲁癌症中心的研究报告，探讨了乳腺癌术前新辅助化疗女性体重指数、体育运动、病理完全缓解、完成化疗之间的相关性。 该病例对照回顾研究首先根据医疗记录，获取2010～2016年早期乳腺癌术前新辅助化疗女性的术后病理完全缓解、术前新辅助化疗完成情况、患者特征。随后，通过电话问卷调查，对诊断前一年的体育运动进行评定。最后，通过无条件逻辑回归模型，确定病理完全缓解和完成化疗的相关因素。 结果，该队列患者共计243例，平均年龄52.9±13.0岁，乳腺癌诊断前平均体重指数29.5±7.0kg/m²，术后病理完全缓解75例（31%）、残留病变168例（69%）。 术后病理完全缓解与残留病变的患者相比，乳腺癌诊断前平均体重指数显著较低（28.2比30.1，P = 0.04）。 乳腺癌诊断前每周运动代谢当量×小时≥7.5与＜7.5的患者相比，术前新辅助化疗完成比例高7.6倍（95%置信区间：1.4～41.2，P = 0.02）。 因此，该研究结果表明，术后病理学完全缓解与诊断前体重指数较低相关，完成术前新辅助化疗与乳腺癌诊断前每周运动量达到美国疾病预防控制中心推荐水平相关。 Breast Cancer. 2019 May 22. [Epub ahead of print] Association between pre-diagnosis BMI, physical activity, pathologic complete response, and chemotherapy completion in women treated with neoadjuvant chemotherapy for breast cancer. Ilana Usiskin, Fangyong Li, Melinda L. Irwin, Brenda Cartmel, Tara Sanft. Yale University School of Medicine, New Haven, USA; Yale School of Public Health, New Haven, USA; Yale Cancer Center, New Haven, USA. PURPOSE: Physical activity and lower BMI have shown benefit for breast cancer survival, but the association between these factors, pathologic complete response (pCR), and chemotherapy completion is not clear. We evaluated whether BMI and physical activity are associated with pCR and chemotherapy completion during neoadjuvant breast cancer treatment. METHODS: We conducted a retrospective case-control study of women given neoadjuvant chemotherapy for stage I-III breast cancer between 2010 and 2016. A medical record review provided pCR, chemotherapy completion, and patient characteristics. A telephone survey assessed physical activity 1 year before diagnosis. Unconditional logistic regression models identified factors associated with pCR and chemotherapy completion. RESULTS: In our cohort (n=243), the average age was 52.9 years (SD 13.0) and mean BMI was 29.5 kg/m² (SD 7.0). Seventy-five (31%) patients had pCR and 168 (69%) had residual disease. Patients with pCR had lower mean BMI than those with residual disease (28.2 (SD) vs. 30.1 (SD), P=0.04). Exercise was associated with completion of chemotherapy (OR 7.6, 95% CI 1.4-41.2, P=0.02). CONCLUSION: Pathologic complete response was associated with lower BMI; chemotherapy completion was associated with exercising at CDC-recommended levels prior to breast cancer diagnosis. KEYWORDS: Breast cancer Physical activity BMI Neoadjuvant chemotherapy Pathologic complete response DOI: 10.1007/s12282-019-00974-3
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