Department of Breast Cancer and Reconstructive Surgery, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
Int J Radiat Oncol Biol Phys. 2012 Apr 1;82(5):2065-71. doi: 10.1016/j.ijrobp.2010.10.077. Epub 2011 May 17.
The aim of the study was to present a new breast cancer recursive partitioning analysis (RPA) prognostic index for patients with newly diagnosed brain metastases as a guide in clinical decision making.
A prospectively collected group of 441 consecutive patients with breast cancer and brain metastases treated between the years 2003 and 2009 was assessed. Prognostic factors significant for univariate analysis were included into RPA.
Three prognostic classes of a new breast cancer RPA prognostic index were selected. The median survival of patients within prognostic Classes I, II, and III was 29, 9, and 2.4 months, respectively (p < 0.0001). Class I included patients with one or two brain metastases, without extracranial disease or with controlled extracranial disease, and with Karnofsky performance status (KPS) of 100. Class III included patients with multiple brain metastases with KPS of ≤60. Class II included all other cases.
The breast cancer RPA prognostic index is an easy and valuable tool for use in clinical practice. It can select patients who require aggressive treatment and those in whom whole-brain radiotherapy or symptomatic therapy is the most reasonable option. An individual approach is required for patients from prognostic Class II.
本研究旨在提出一种新的乳腺癌递归分区分析（RPA）预后指数，以指导临床决策，用于治疗新发脑转移的患者。
评估了 2003 年至 2009 年间治疗的 441 例连续乳腺癌伴脑转移患者的前瞻性收集组。将单因素分析中有意义的预后因素纳入 RPA。
选择了新的乳腺癌 RPA 预后指数的三个预后类别。在预后类别 I、II 和 III 中的患者的中位生存期分别为 29、9 和 2.4 个月（p<0.0001）。类别 I 包括有一个或两个脑转移、无颅外疾病或有控制的颅外疾病、卡氏功能状态（KPS）为 100 的患者。类别 III 包括有 KPS≤60 的多发脑转移患者。类别 II 包括所有其他病例。
乳腺癌 RPA 预后指数是一种在临床实践中易于使用且有价值的工具。它可以选择需要积极治疗的患者，以及选择全脑放疗或对症治疗最合理的患者。对于预后类别 II 的患者，需要采取个体化的方法。
