女性性别和年龄较年轻被报道为高呕吐原性化疗（highly emetogenic chemotherapy，HEC）引起的化疗诱导恶心呕吐（chemotherapy-induced nausea and vomiting，CINV）的危险因素，但其潜在机制尚未阐明。本研究的目的是阐明绝经对CINV的影响。本回顾性观察性研究分析了2018年1月至2020年6月间首次接受围手术期腺苷环化疗方案治疗乳腺癌的连续病患的数据。终点是CINV（呕吐、≥2级恶心、完全缓解[CR]失败）与绝经、卵泡刺激素（follicle-stimulating hormone，FSH）/雌二醇（estradiol，E2）之间的关联。共分析了639名患者的数据。其中，109名患者（17.1%）接受奥氮平（四种抗恶心方案）治疗，530名患者（82.9%）未接受奥氮平（三种抗恶心方案）治疗。维持绝经前状态（经期停止≥12个月）在单变量分析中与≥2级恶心和CR失败显著相关，但在多变量分析中无显著关联。维持绝经前FSH/E2组（根据血清水平定义：FSH <40 mIU/mL，E2 ≥20 pg/mL）与维持绝经后FSH/E2组（FSH ≥40 mIU/mL，E2 <20 pg/mL）相比，≥2级恶心的发生率显著较高（48.8% vs. 18.8%，p = 0.023）。我们的结果表明，由于绝经导致的FSH和E2的变化可能会影响恶心的严重程度，FSH和E2（尤其是FSH）水平可能是CINV风险评估的有用指标。© 2023 The Authors. 癌症医学由John Wiley & Sons Ltd出版。

Female sex and younger age are reported risk factors for chemotherapy-induced nausea and vomiting (CINV) in highly emetogenic chemotherapy, but the underlying mechanism has not been elucidated. The purpose of this study was to clarify the impact of menopause on CINV.This retrospective observational study analyzed data from consecutive patients who received their first cycle of perioperative anthracycline-based chemotherapy for breast cancer between January 2018 and June 2020. The endpoints were association between CINV (vomiting, ≥Grade 2 nausea, complete response [CR] failure) and menopause as well as the association between CINV and follicle-stimulating hormone [FSH]/estradiol [E2].Data for 639 patients were analyzed. Among these patients, 109 (17.1%) received olanzapine (four antiemetic combinations) and 530 (82.9%) did not (three antiemetic combinations). Premenopausal state (amenorrhea lasting ≥12 months) was significantly associated with ≥Grade 2 nausea and CR failure in univariate analysis but not in multivariate analysis. The premenopausal FSH/E2 group (defined by serum levels; FSH <40 mIU/mL and E2 ≥20 pg/mL) had a significantly higher rate of ≥Grade 2 nausea than the postmenopausal FSH/E2 group (FSH ≥40 mIU/mL and E2 <20 pg/mL) (48.8% vs. 18.8%, p = 0.023).Our results suggest that changes in FSH and E2 due to menopause may affect the severity of nausea and that FSH and E2 (especially FSH) levels might be useful indicators for CINV risk assessment.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.