PURPOSE To investigate predictors of treatment interruption and early discontinuation of adjuvant hormonal therapy (HT) in a retrospective cohort of women with newly diagnosed hormone receptor-positive (HR +) breast cancer. METHODS Eligible cases were identified from a single institutional tumor registry from 2009 to 2015. Patients were followed from initiation of adjuvant HT for a minimum of one year through December 1, 2016. Predictors of treatment interruption or early discontinuation were analyzed with Cox proportional hazards regression models. RESULTS With a median follow-up time of 3.0 years (IQR 1.5-4.5), 22 women (10.9%) discontinued HT early and 47 (23.4%) had at least one treatment interruption of > 14 days. Adjusted Cox proportional hazards regression models showed that women with pre-existing affective disorders were more likely to discontinue therapy early (HR 3.15; 95% CI 1.35-7.37), while those with pre-existing chronic pain disorders were at increased risk for treatment interruption (HR 2.24; 95% CI 1.20-4.19). HT-related symptoms were the most commonly reported reason for HT interruption or discontinuation. Women who experienced severe treatment-related symptoms were at increased risk for both HT interruption (HR 2.64; 95% CI 1.07-6.50) and HT discontinuation (HR 3.48; 95% CI 1.20-10.1). CONCLUSIONS This study showed that HT interruptions and discontinuation were common, often associated with HT-related symptoms. Clinicians caring for breast cancer patients on HT should monitor closely for treatment-emergent symptoms, especially women with pre-existing disorders, and support them to continue therapy through aggressive symptom management and other patient-centered approaches.

中文翻译：

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激素受体阳性乳腺癌患者的治疗中断和激素治疗的终止。


目的 在新诊断的激素受体阳性 (HR +) 乳腺癌女性回顾性队列中研究治疗中断和早期停止辅助激素治疗 (HT) 的预测因素。方法 从 2009 年至 2015 年从单一机构肿瘤登记处筛选出符合条件的病例。从开始辅助 HT 起至 2016 年 12 月 1 日对患者进行至少一年的随访。使用 Cox 比例风险回归分析治疗中断或提前终止的预测因素模型。结果 中位随访时间为 3.0 年 (IQR 1.5-4.5)，22 名女性 (10.9%) 提前停止 HT，47 名 (23.4%) 至少有一次 14 天 > 的治疗中断。调整后的 Cox 比例风险回归模型显示，患有先前存在情感障碍的女性更有可能提前停止治疗（HR 3.15；95% CI 1.35-7.37），而患有先前存在慢性疼痛障碍的女性则中断治疗的风险增加（HR 2.24；95% CI 1.20-4.19）。 HT 相关症状是 HT 中断或终止的最常见原因。经历严重治疗相关症状的女性中断激素治疗（HR 2.64；95% CI 1.07-6.50）和中断激素治疗（HR 3.48；95% CI 1.20-10.1）的风险增加。结论 这项研究表明，HT 中断和终止很常见，通常与 HT 相关症状有关。治疗接受 HT 的乳腺癌患者的临床医生应密切监测治疗中出现的症状，尤其是患有既往疾病的女性，并支持她们通过积极的症状管理和其他以患者为中心的方法继续治疗。