title: Randomized trial of adjuvant tamoxifen and/or goserelin in premenopausal breast cancer--self-rated physiological effects and symptoms.
abstract: After primary surgery, 149 premenopausal breast cancer patients, with node-negative disease, were randomized to one of four treatment groups: goserelin, tamoxifen, goserelin plus tamoxifen or to a systematically untreated control group. The aim was to assess the effects of adjuvant endocrine therapy in terms of physical symptoms and perception of anxiety and depressive symptoms. Assessments were made before randomization, at 3-4 months and at 12 months. Treatment with goserelin resulted in early and more intense menopausal symptoms, while the effects of tamoxifen were slower and milder. The side effects with goserelin appeared to be alleviated by concurrent tamoxifen except for vasomotor symptoms (hot flashes, sweating, feeling warm). No significant group differences were found for anxiety and depressive symptoms. In conclusion, chemical castration with goserelin was associated with the highest level of physical symptoms. The group treated with tamoxifen alone showed the lowest levels of symptoms among the treatment groups, except for vaginal discharge and irregular bleedings.
authors.affiliation: Department of Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Nystedt
authors.forename: G
authors.initials: G
authors.lastname: Berglund
authors.forename: C
authors.initials: C
authors.lastname: Bolund
authors.forename: Y
authors.initials: Y
authors.lastname: Brandberg
authors.forename: T
authors.initials: T
authors.lastname: Fornander
authors.forename: L E
authors.initials: LE
authors.lastname: Rutqvist
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001007:Anxiety / Q000139:chemically induced / Q000209:etiology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003863:Depression / Q000139:chemically induced / Q000209:etiology; D005260:Female; D017273:Goserelin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D017697:Premenopause / Q000187:drug effects* / Q000502:physiology; D013629:Tamoxifen / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014621:Vagina / Q000187:drug effects / Q000503:physiopathology; D014666:Vasomotor System / Q000187:drug effects / Q000503:physiopathology
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen; D017273:Goserelin