Radiation Oncology Department, Regional Cancer Centre of Basilicata (CROB), Via Padre Pio 1, 85028 Rionero in Vulture, PZ, Italy.
Med Oncol. 2012 Jun;29(2):459-65. doi: 10.1007/s12032-011-9869-0. Epub 2011 Feb 26.
To evaluate overall survival, distant metastases-free survival and local relapse-free survival rates in a subgroup of patients affected by breast cancer expressing Her-2/neu. Data of 195 women affected by very early-stage breast cancer (pT1a-b pN0) who underwent whole breast radiotherapy after conservative surgery with or without chemotherapy and/or hormone therapy between January 2000 and December 2006 were evaluated. Chi-square test was used to compare the distribution of variables (age, tumour histology, oestrogens and progesterone receptors, tumour grading and adjuvant chemotherapy) between Her-2-positive and Her-2-negative patients. Survival rates were analysed with Kaplan-Meier curves; impact of variables on poor outcome was evaluated with Cox regression method. Median follow-up time was 63.5 months (range 13.8-113.6). Her-2/neu-positive patients (32/16.4%), compared to Her-2/neu-negative patients (163/83.6%), were younger (P = 0.0001), were affected by ductal infiltrating carcinoma (P = 0.039), had negative oestrogens receptors (P = 0.0001) and were not treated with chemotherapy (P = 0.001). Her-2-positive patients had lower overall survival (P = 0.00001) and lower distant metastases-free survival (P = 0.00001) compared to Her-2-negative patients, but no difference in local relapse-free survival was found between the two groups (P = 0.28). After multivariate analysis, Her-2-positive status was a prognostic factor for overall survival (P = 0.00001) and for distant metastases-free survival (P = 0.0001), but not for local relapse-free survival (P = 0.97). Her-2-positive patients have lower overall survival and distant metastases-free survival when compared to Her-2 negative patients but similar local relapse-free survival rates. These patients could be treated with conservative surgery, if feasible, but should receive more aggressive and tailored systemic adjuvant therapies.
评估表达 Her-2/neu 的乳腺癌患者亚组的总生存率、远处无转移生存率和局部无复发生存率。评估了 195 名接受保乳手术联合或不联合化疗和/或激素治疗的早期乳腺癌（pT1a-b pN0）患者的资料，这些患者在 2000 年 1 月至 2006 年 12 月期间接受了全乳放疗。卡方检验用于比较 Her-2 阳性和 Her-2 阴性患者之间的变量（年龄、肿瘤组织学、雌激素和孕激素受体、肿瘤分级和辅助化疗）分布。采用 Kaplan-Meier 曲线分析生存率；Cox 回归法评估变量对不良预后的影响。中位随访时间为 63.5 个月（范围 13.8-113.6）。与 Her-2/neu 阴性患者（163/83.6%）相比，Her-2/neu 阳性患者（32/16.4%）更年轻（P = 0.0001），浸润性导管癌（P = 0.039），雌激素受体阴性（P = 0.0001），未接受化疗（P = 0.001）。与 Her-2/neu 阴性患者相比，Her-2 阳性患者的总生存率（P = 0.00001）和远处无转移生存率（P = 0.00001）较低，但两组的局部无复发生存率无差异（P = 0.28）。多变量分析后，Her-2 阳性状态是总生存率（P = 0.00001）和远处无转移生存率（P = 0.0001）的预后因素，但不是局部无复发生存率的预后因素（P = 0.97）。与 Her-2 阴性患者相比，Her-2 阳性患者的总生存率和远处无转移生存率较低，但局部无复发生存率相似。这些患者如果可行，可行保守手术治疗，但应接受更积极和个体化的系统辅助治疗。
