Ding Xiao-yan, Fan Ying, Ma Fei, Li Qing, Wang Jia-yu, Yuan Peng, Zhang Pin, Xu Bing-he
Cancer Hospital & Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
Zhonghua Yi Xue Za Zhi. 2012 Dec 11;92(46):3279-82.
To explore the therapeutic outcomes of various first-line regimens and prognostic factors for hormone receptor positive (HR+) breast cancer (BrCa) patients with bone-only metastases.
A total of 139 HR+ BrCa patients with bone-only metastases between January 1, 2005 and October 31, 2010 were retrospectively reviewed. Their clinicopathologic characteristics, various treatment regimens and clinical survival factors were analyzed. Furthermore, the effects of various therapeutic regimens on skeletal-related events (SREs) were explored.
In this cohort, 99 patients received first-line chemotherapeutic regimens and 40 had first-line endocrine drugs. Their median overall survival time was 61 months. No significant difference was noted in 5-year overall survival rate between first-line chemotherapy group (49.4%) and first-line endocrine group (44.3%) (hazard ratio (HR) 0.687, 95% confidence interval (CI) 0.307 - 1.539, P = 0.362). Furthermore, interval of disease-free survival > 3 years and number of positive lymph nodes < 10 were favorable prognostic factors by univariate analyses (HR = 0.333, 95%CI 0.138 - 0.803, P = 0.014; HR = 0.239, 95%CI 0.102 - 0.562, P = 0.001); they were also independent favorable prognostic factors by multivariate Cox-regression analyses. The proportion of patients with SREs decreased in the first-line chemotherapy group compared with the first-line endocrine group (45/99 (45.4%) vs 25/40 (62.5%)). Nonetheless, the difference was insignificant (P = 0.092).
Interval of disease-free survival > 3 years and number of positive lymph nodes < 10 are independent favorable prognostic factors. The overall survival of HR+ BrCa patients with bone-only metastases is not significantly different between two groups. First-line chemotherapy may lower the incidence of SREs. Both endocrine therapy and chemotherapy are effective for HR+ BrCa patients with bone-only metastases and they should be individualized.
探讨激素受体阳性（HR+）仅发生骨转移的乳腺癌（BrCa）患者各种一线治疗方案的疗效及预后因素。
回顾性分析2005年1月1日至2010年10月31日期间139例HR+仅发生骨转移的BrCa患者。分析其临床病理特征、各种治疗方案及临床生存因素。此外，探讨各种治疗方案对骨相关事件（SREs）的影响。
该队列中，99例患者接受一线化疗方案，40例接受一线内分泌药物治疗。他们的中位总生存时间为61个月。一线化疗组（49.4%）和一线内分泌组（44.3%）的5年总生存率无显著差异（风险比（HR）0.687，95%置信区间（CI）0.307 - 1.539，P = 0.362）。此外，单因素分析显示无病生存期>3年和阳性淋巴结数<10是有利的预后因素（HR = 0.333，95%CI 0.138 - 0.803，P = 0.014；HR = 0.239，95%CI 0.102 - 0.562，P = 0.001）；多因素Cox回归分析显示它们也是独立的有利预后因素。与一线内分泌组相比，一线化疗组发生SREs的患者比例有所下降（45/99（45.4%）对25/40（62.5%））。然而，差异无统计学意义（P = 0.092）。
无病生存期>3年和阳性淋巴结数<10是独立的有利预后因素。两组HR+仅发生骨转移的BrCa患者的总生存率无显著差异。一线化疗可能降低SREs的发生率。内分泌治疗和化疗对HR+仅发生骨转移的BrCa患者均有效，应个体化治疗。
