Kontani Keiichi, Hashimoto Shin-Ichiro, Murazawa Chisa, Norimura Shoko, Tanaka Hiroaki, Ohtani Masahiro, Fujiwara-Honjo Naomi, Date Manabu, Houchi Hitoshi, Yokomise Hiroyasu
Department of Respiratory, Breast and Endocrine Surgery, Kagawa University Faculty of Medicine, Kagawa University Hospital, Kita-gun, Kagawa 761-0793;
Department of Surgery, Takamatsu Red Cross Hospital, Takamatsu, Kagawa 760-0017;
Mol Clin Oncol. 2013 Mar;1(2):225-230. doi: 10.3892/mco.2012.49. Epub 2012 Dec 10.
The objective of treatment for metastatic breast cancer (MBC) is to control the disease or disease-related symptoms. Prolonged survival has also often been achieved by chemotherapeutic regimens in this setting. Long-term administration of one therapeutic regimen is essential for prolonging survival as well as for maintaining quality of life in these patients. In this study, we focused on time to treatment failure (TTF) as a parameter that predicts patient survival and we retrospectively compared clinical outcomes of patients with MBC who showed TTF of ≥12 months (26 patients) and <12 months (29 patients). The proportion of hormone receptor-positive tumors and the number of prior chemotherapy regimens for MBC were significantly higher and tumor grade was lower in patients with TTF ≥12 months compared to those with TTF <12 months. With regard to clinical outcomes, the objective response rate (ORR) in patients with TTF ≥12 months was significantly higher and median time to progression (TTP) and overall survival (OS) were longer compared to those with TTF <12 months. Of note, the proportion of patients who received metronomic regimens was significantly higher in patients with TTF ≥12 months compared to those with TTF <12 months (80.8 vs. 24.1%, P=0.00003). To assess the clinical benefit of metronomic regimens, the efficacy in patients receiving metronomic and those receiving non-metronomic regimens was compared. Although there was no difference in ORR between the two groups, median TTP and OS were significantly longer in the metronomic compared to the non-metronomic group (TTP: 30 vs. 4 months, P=0.0017; OS: 68 vs. 28 months, P=0.0005). The results suggested that metronomic chemotherapy is useful for palliative care and also improved clinical outcomes as a regimen for which long-term administration may be expected.
转移性乳腺癌（MBC）的治疗目标是控制疾病或与疾病相关的症状。在这种情况下，化疗方案也常常能实现延长生存期。长期使用一种治疗方案对于延长这些患者的生存期以及维持生活质量至关重要。在本研究中，我们将治疗失败时间（TTF）作为预测患者生存的参数，并回顾性比较了TTF≥12个月的MBC患者（26例）和TTF<12个月的MBC患者（29例）的临床结局。与TTF<12个月的患者相比，TTF≥12个月的患者中激素受体阳性肿瘤的比例显著更高且MBC的既往化疗方案数量更多，而肿瘤分级更低。关于临床结局，与TTF<12个月的患者相比，TTF≥12个月的患者客观缓解率（ORR）显著更高，中位疾病进展时间（TTP）和总生存期（OS）更长。值得注意的是，与TTF<12个月的患者相比，TTF≥12个月的患者中接受节拍化疗方案的患者比例显著更高（80.8%对24.1%，P=0.00003）。为了评估节拍化疗方案的临床获益，比较了接受节拍化疗方案和非节拍化疗方案患者的疗效。尽管两组之间的ORR没有差异，但与非节拍化疗组相比，节拍化疗组的中位TTP和OS显著更长（TTP：30个月对4个月，P=0.0017；OS：68个月对28个月，P=0.0005）。结果表明，节拍化疗对姑息治疗有用，并且作为一种有望长期使用的方案也改善了临床结局。
