Effects of timing of chemotherapy after breast cancer surgery on patient's immune function and quality of life / 中国基层医药

ABSTRACT

Objective:To investigate the effects of the timing of chemotherapy after breast cancer surgery on patient's immune function and quality of life.Methods:A total of 100 patients who underwent modified radical mastectomy for breast cancer from January 2017 to January 2019 in Jining No. 1 People's Hospital were included in this study. These patients were randomly divided into a control group and an early chemotherapy group ( n = 50/group). Patients in the control group underwent chemotherapy 4-6 weeks after surgery. Patients in the early chemotherapy group received chemotherapy 2 weeks after surgery. The chemotherapy regimens were the same in the two groups. The levels of CD 4+, CD 8+, CD 4+/CD 8+, immunoglobulin A (IgA), and immunoglobulin G (IgG) were measured before and after chemotherapy in each group. Chemotherapy-related reverse reactions and infections were recorded. The quality of life was evaluated in each group at the last follow-up. Results:Before chemotherapy, there were no significant differences in CD 4+, CD 8+, CD 4+/CD 8+, IgA, and IgG levels between the two groups (all P > 0.05). After chemotherapy, CD 4+ and CD 4+/CD 8+ levels in the early chemotherapy group were (51.76 ± 5.21)% and (2.00 ± 0.25), respectively, which were significantly higher than (48.21 ± 4.78)% and (1.70 ± 0.21) in the control group ( t = 3.55, 4.98, both P < 0.05). After chemotherapy, the CD 8+ level in the early chemotherapy group was (25.93±2.43)%, which was significantly lower than (28.29 ± 2.31)% in the control group ( t = 6.50, P < 0.05). Serum IgA and IgG levels in the early chemotherapy group were (3.24 ± 0.38) g/L and (9.27 ± 1.04) g/L, respectively, which were significantly higher than (2.75 ± 0.37) g/L and (8.43 ± 0.97) g/L in the control group ( t = 6.53, 4.18, both P < 0.05). During chemotherapy, there was no significant difference in the incidence of reverse reactions between the two groups (all P > 0.05). The incidence of infections was significantly lower in the early chemotherapy group than the control group ( P < 0.05). At the last follow-up, generic quality of life inventory-74 scores in the early chemotherapy group were significantly higher than those in the control group (all P < 0.05). Conclusion:Early chemotherapy can markedly reduce the effects of chemotherapy on the immune function of patients after breast cancer surgery, decrease the incidence of infections, and improve quality of life.