Meme kanserinde hormonoterapi kullanımı ve metabolik sendrom arasındaki ilişki

Abstract

ÖZET Amaçlar: Meme kanseri tanısı almış hastalarda, hormonoterapi ilaçlarının kullanılmasıyla metabolik sendrom benzeri bulgulara neden olup olmadığını araştırmak ve uzun dönemde ilaçların etkilerini karşılaştırmak. Yöntemler : Bu retrospektif dosya analizi Ocak 2019 ile Nisan 2022 tarihleri arasında Radyasyon Onkolojisi kliniğine başvuran meme kanseri hastalarında gerçekleştirildi. Meme kanseri tanısı alan, postmenopozal dönemde olan ve önceden diyabet, hipertansiyon gibi herhangi bir kronik hastalığı bulunmayan 75 hastanın dosyaları çalışmaya dahil edildi. Adjuvan dönemde farklı etken maddeli ilaç (tamoksifen sitrat, letrozol veya anastrazol) başlanan hastalar 3 grupta incelendi. İlaçlara başlanmadan önce ve ilaç başlandıktan 6 ay sonra bel çevresi kalınlığı, vücut ağırlığı, kan basıncı ve kan biyokimyasal testleri (açlık kan şekeri, lipid düzeyleri) ölçüldü ve değerler geriye dönük olarak karşılaştırıldı. Bulgular : Çalışmaya dahil edilen 75 hastadan tamoksifen kullanan hastaların yaş ortalaması 59.6; letrozol kullanan hastaların yaş ortalaması 59.12 yıl ve anastrozol kullanan hastaların yaş ortalaması 63.56 yıldı. Tamoksifen kullanan grupta açlık kan şekeri (p:0.014) ve bel çevresinde kalınlık artışı vardı (p:0.009). Letrozol ve anastrazol kollarında ise açlık kan şekeri, kilo, bel çevresi kalınlığı, tansiyon ve lipit düzeylerinde artış vardı (hepsinde p:0.0001). Ayrıca ilaçlar başlandıktan sonra gelişen diyabet,hipertansiyon gibi ek hastalıklar belirlendi. Sonuç: Meme kanserinde kullanılan hormonoterapi ilaçlar ile metabolik sendrom arasında ciddi bir bağlantı olduğunu düşünüyoruz. Hastaların çoğunda kan lipit, AKŞ, kilo, bel çevresi artışları saptarken, özellikle aromataz inhibitörü kullanan gruplarda bu artışların anlamlı derecede daha fazla olduğunu gözlemledik. Bu hastaların hormonoterapi başlamadan önce ayrıntılı tetkik edilmesi gerekiyor. Hastalara diyet (şeker ve yağ kısıtlaması), aktif hayat ve spor önerilmelidir. Ayrıca ilaçlara bağlı gelişen ek hastalıkların erken dönemde tanısının konup, gerekli ilaçların başlanması uygun olacaktır.

Keywords

• Meme kanserinde aromataz inhibitörü
• metabolik sendrom
• hormon reseptörü pozitif meme kanseri

Using hormonotherapy in breast cancer and its relationship with metabolic syndrome

Abstract

Aims: This study aims to investigate whether the use of hormonotherapy pharmaceuticals causes metabolic syndrome-like symptoms in patients diagnosed with breast cancer and to compare the long-term effects of the drugs. Methods: This retrospective file analysis was conducted on breast cancer patients who presented to the Radiation Oncology clinic between January 2019 and April 2022. Files of 75 patients diagnosed with breast cancer, postmenopausal, and without any previous chronic diseases such as diabetes or hypertension were included in the study. Patients who were started on medications with different active ingredients (tamoxifen citrate, letrozole or anastrazole) in the adjuvant period were examined in 3 groups. Waist circumference thickness, body weight, blood pressure, and blood biochemical tests (blood glucose, lipid levels) were measured before and 6 months after the start of the drugs, and the values were compared retrospectively. Results: Of the 75 patients included in the study, the average age of patients using tamoxifen was 59.6; The average age of patients using letrozole was 59.12 years and the average age of patients using anastrozole was 63.56 years. There was an increase in fasting blood sugar (p:0.014) and waist circumference (p:0.009) in the tamoxifen group. There was an increase in fasting blood sugar, weight, waist circumference, blood pressure and lipid levels in the letrozole and anastrazole arms (p<0.0001 for all). Furthermore, comorbidities such as diabetes mellitus and hypertension that developed after using drugs were ascertained. Conclusion: We think that there is a significant association between hormonotherapy medicines used in breast cancer and metabolic syndrome. While we found increases in blood lipids, FBG, body weight, and waist circumference in most of the patients, we observed that these increases were significantly higher in the groups using aromatase inhibitors. These patients should be examined in detail before starting hormone therapy. Diet, active lifestyle, and sports should be recommended.

Keywords

• Aromatase inhibitor in breast cancer
• metabolic syndrome
• hormone receptor-positive breast cancer

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