Kyung-Lak Son1, Dooyoung Jung2, Kwang-Min Lee3,4,5, Heesung Hwang6, JooYoung Lee7, Tae-Yong Kim8,9, Seock-Ah Im8,9,10, Kyung-Hun Lee8,9, David Spiegel11, Bong-Jin Hahm12,13. 1. Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, South Korea. 2. Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea. 3. Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, South Korea. 4. Department of Public Health Medical Service, Seoul National University Hospital, Seoul, South Korea. 5. Department of Psychiatry, Chungcheongnam-do Seosan Medical Center, Seosan, South Korea. 6. Department of Psychiatry, Bucheon Korea Hospital, Bucheon, South Korea. 7. Department of Psychiatry, University of Maryland Medical Center, Baltimore, MD, USA. 8. Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea. 9. Cancer Research Institute, Seoul National University, Seoul, South Korea. 10. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea. 11. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA. 12. Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, South Korea. hahmbj@gmail.com. 13. Department of Psychiatry, Seoul National University Hospital, Seoul, South Korea. hahmbj@gmail.com.
Abstract
PURPOSE: Adjuvant chemotherapy in patients with breast cancer often causes hot flashes, impairing quality of life. However, the chronobiological or psychiatric factors associated with the development of chemotherapy-induced hot flashes (CIHFs) remain undetermined. The purpose of this study was to investigate whether chronotype was associated with the incidence of CIHFs. METHODS: A total of 119 premenopausal women with non-metastatic breast cancer awaiting adjuvant chemotherapy after surgery without hot flashes were included. The presence of CIHF was defined as having moderate to severe hot flashes, as measured by the subscale of hot flashes in the Menopause Rating Scale, at 4 weeks after the completion of chemotherapy. Chronotype (Morning/Intermediate/Evening) was assessed with the Composite Scale of Morningness before adjuvant chemotherapy. To examine the association between chronotype and CIHF, we built logistic regression models, adjusting for age, body mass index, sleep quality, and radiation therapy. RESULTS: CIHF occurred in 50.4% of participants. Morning type was inversely associated with CIHF (reference: Intermediate type, odds ratio [OR], 0.37; 95% confidence interval [CI], 0.16-0.94; p = 0.040) in the univariate model, and the association remained significant (OR, 0.37; CI, 0.13-0.96; p = 0.045) after adjusting for age, body mass index, sleep quality, and radiation therapy. CONCLUSIONS: Morning chronotype is a protective factor against the development of CIHF in patients with breast cancer. Chronotypes should be assessed and considered in the prediction and management of CIHF.
PURPOSE: Adjuvant chemotherapy in patients with breast cancer often causes hot flashes, impairing quality of life. However, the chronobiological or psychiatric factors associated with the development of chemotherapy-induced hot flashes (CIHFs) remain undetermined. The purpose of this study was to investigate whether chronotype was associated with the incidence of CIHFs. METHODS: A total of 119 premenopausal women with non-metastatic breast cancer awaiting adjuvant chemotherapy after surgery without hot flashes were included. The presence of CIHF was defined as having moderate to severe hot flashes, as measured by the subscale of hot flashes in the Menopause Rating Scale, at 4 weeks after the completion of chemotherapy. Chronotype (Morning/Intermediate/Evening) was assessed with the Composite Scale of Morningness before adjuvant chemotherapy. To examine the association between chronotype and CIHF, we built logistic regression models, adjusting for age, body mass index, sleep quality, and radiation therapy. RESULTS: CIHF occurred in 50.4% of participants. Morning type was inversely associated with CIHF (reference: Intermediate type, odds ratio [OR], 0.37; 95% confidence interval [CI], 0.16-0.94; p = 0.040) in the univariate model, and the association remained significant (OR, 0.37; CI, 0.13-0.96; p = 0.045) after adjusting for age, body mass index, sleep quality, and radiation therapy. CONCLUSIONS: Morning chronotype is a protective factor against the development of CIHF in patients with breast cancer. Chronotypes should be assessed and considered in the prediction and management of CIHF.
Entities:
Keywords:
Adjuvant chemotherapy; Breast cancer; Chemotherapy-induced hot flashes; Chronotype
Authors: Russell G Foster; Stuart N Peirson; Katharina Wulff; Eva Winnebeck; Céline Vetter; Till Roenneberg Journal: Prog Mol Biol Transl Sci Date: 2013 Impact factor: 3.622