Ahn Sung Gwe, Kim Sung Hyun, Lee Hak Min, Lee Seung Ah, Jeong Joon
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Department of Surgery, Eulji University College of Medicine, Seoul, Korea.
J Breast Cancer. 2014 Dec;17(4):350-5. doi: 10.4048/jbc.2014.17.4.350. Epub 2014 Dec 26.
A growing body of evidence indicates that zoledronic acid (ZA) can improve the clinical outcome in patients with breast cancer and low estrogen levels. In the present study, we aimed to investigate the survival benefit of ZA administration in postmenopausal Korean women with breast cancer who were also receiving aromatase inhibitors.
Between January 2004 and December 2010, 235 postmenopausal breast cancer patients undergoing aromatase inhibitor therapy were investigated. All patients were postmenopausal, as confirmed by laboratory tests. Of these patients, 77 received adjuvant upfront ZA for at least 1 year in addition to conventional adjuvant treatment. The remaining 158 patients never received ZA and were treated according to the St. Gallen guidelines.
The baseline characteristics for ZA treatment were not different between the two groups. The median follow-up time was 62 months, and the patients who received ZA in addition to aromatase inhibitors showed a better recurrence-free survival compared to those who received aromatase inhibitors alone (p=0.035). On multivariate analysis, the patients who received ZA showed a better recurrence-free survival independent of the tumor size, nodal status, progesterone receptor, and histological grade. For this model, Harrell c index was 0.743. The hazard ratio of ZA use for recurrence-free survival was 0.12 (95% confidence interval, 0.01-0.99).
Our findings suggest that upfront use of ZA as part of adjuvant treatment can offer a survival benefit to postmenopausal breast cancer patients receiving aromatase inhibitor treatment.
越来越多的证据表明，唑来膦酸（ZA）可改善雌激素水平低的乳腺癌患者的临床结局。在本研究中，我们旨在调查ZA给药对同时接受芳香化酶抑制剂治疗的绝经后韩国乳腺癌女性的生存获益情况。
2004年1月至2010年12月期间，对235例接受芳香化酶抑制剂治疗的绝经后乳腺癌患者进行了调查。所有患者经实验室检查证实均已绝经。在这些患者中，77例除接受常规辅助治疗外，还接受了至少1年的辅助性早期ZA治疗。其余158例患者从未接受过ZA治疗，而是根据圣加伦指南进行治疗。
两组之间ZA治疗的基线特征无差异。中位随访时间为62个月，与仅接受芳香化酶抑制剂治疗的患者相比，同时接受ZA和芳香化酶抑制剂治疗的患者无复发生存期更好（p = 0.035）。多因素分析显示，接受ZA治疗的患者无复发生存期更好，且与肿瘤大小、淋巴结状态、孕激素受体和组织学分级无关。对于该模型，Harrell c指数为0.743。ZA用于无复发生存期的风险比为0.12（95%置信区间，0.01 - 0.99）。
我们的研究结果表明，早期使用ZA作为辅助治疗的一部分可为接受芳香化酶抑制剂治疗的绝经后乳腺癌患者带来生存获益。
