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1、SymptomsandTreatmentinCancerTherapy：AnneliesH.Boekhouta,JosH.Beijnena,b,JanH.M.Schellensa,b【关键词】Hot,flashesaNetherlandsCancerInstitute/AntonivanLeeusterdam,TheNetherlands;bDivisionofBiomedicalAnalysis,FacultyofPharmaceuticalSciences,UtrechtUniversity,Utrecht,TheNe
2、therlandsKeyIOLOGYOFHOTFLASHESDefinitionsAhotflashisasubjectivesensationofheatthatisassociatedperature.Sayacpanythehotflash,andenmayalsoreportnightsinutesandvaryfrommildtointolerable.Someenesamonth,enplainthatsymptomsoccureveryhour[11,12]."Hotflashes,""vasomotorsy
3、mptoms,""hotflushes,""nightsactericsymptoms"arealltermsusedtodescribethesamephenomenon.Theterm"hotflash"isusedinthisarticle.PathophysiologyTheexactpathophysiologicalmechanismsoftheoccurrenceofhotflashesareunknooregulatorysetpointinthehypothalamusasaresultofdecreas
4、edestrogenordecreasedgonadalsteroidlevels.Studiessuggestthatestrogenbalanceinplasmalevelsofseveralneurotransmitters.Norepinephrineistheprimaryneurotransmitterresponsibleforlooregulatorysetpoint.Plasmalevelsofnorepinephrinemetabolitesareincreased.Theeffectofhighern
5、orepinephrineandserotoninlevelsistolooregulatorysetpoint,itterserotoninmightalsohaveanimportantroleinthermoregulation.Decreasedbloodserotoninlevelsandupregulationofserotoninreceptorsinthehypothalamusareassociatedoregulatorysetpointmightbedependentonthebalanceofthe
6、seplasmalevels,andachangeinthebalancemaytriggerthehotflashsensation[11,13,14].PrevalenceofHotFlashesHotflashesaffecttenopausalen,and10%20%ofallpostmenopausalenfindthemnearlyintolerable[15].Hotflashesarethemostusualplaintofperimenopausalandpostmenopausalen.Variouse
7、ntities―suchasspicyfoods,alcoholanddrugs,systemicdisease,neurologicaldisorders,androgendeprivation,andcarcinoidtumors―couldleadtoflashingreactions[16,17].Hotflashesareverymoninbreastcancersurvivorsaftertreatmentaseadjuvanttreatment,suchastamoxifen.Theyaresignifica
8、ntlymorefrequentandmoresevereinbreastcancerpatientsthaninenoxifen,aromataseinhibitors,orsuppressionofovarianfunctionintheadjuvanttreatmentofbreastcancer
