Charehbili A, Hamdy N A T, Smit V T H B M, Kessels L, van Bochove A, van Laarhoven H W, Putter H, Meershoek-Klein Kranenbarg E, van Leeuwen-Stok A E, van der Hoeven J J M, van de Velde C J H, Nortier J W R, Kroep J R
Leiden University Medical Center, Department of Medical Oncology, The Netherlands; Leiden University Medical Center, Department of Surgery, The Netherlands.
Leiden University Medical Center, Department of Endocrinology & Metabolic Diseases, The Netherlands.
Breast. 2016 Feb;25:69-74. doi: 10.1016/j.breast.2015.10.005. Epub 2015 Nov 21.
Serum levels of 25-OH vitamin D3 (vitamin D) have been shown to be prognostic for disease-free survival in patients with breast cancer. We investigated the predictive value of these levels for pathological response after neoadjuvant chemotherapy in patients with breast cancer taking part in the NEOZOTAC phase-III trial. Additionally, the effect of chemotherapy on vitamin D levels was studied.
Serum vitamin D was measured at baseline and before the last cycle of chemotherapy. The relationship between these measurements and clinical outcome, as defined by pathological complete response in breast and lymph nodes (pCR) was examined.
Baseline and end of treatment vitamin D data were available in 169 and 91 patients, respectively. Median baseline vitamin D values were 58.0 nmol/L. In patients treated with chemotherapy only, serum vitamin D levels decreased during neoadjuvant chemotherapy (median decrease of 16 nmol/L, P = 0.003). The prevalence of vitamin D levels < 50 nmol/L increased from 38.3% at baseline to 55.9% after chemotherapy. In the total population, baseline and end of therapy vitamin D levels were not related to pathological response. No associations were found between pCR and vitamin D level changes.
The significant decrease in vitamin D post-neoadjuvant chemotherapy suggests that vitamin D levels should be monitored and in case of decrease of vitamin D levels, correction may be beneficial for skeletal health and possibly breast cancer outcome.
血清25-羟基维生素D3（维生素D）水平已被证明可预测乳腺癌患者的无病生存期。我们调查了参与NEOZOTAC III期试验的乳腺癌患者新辅助化疗后这些水平对病理反应的预测价值。此外，还研究了化疗对维生素D水平的影响。
在基线和化疗最后一个周期前测量血清维生素D。检查这些测量值与临床结局之间的关系，临床结局定义为乳腺和淋巴结的病理完全缓解（pCR）。
分别有169例和91例患者获得了基线和治疗结束时的维生素D数据。基线维生素D值中位数为58.0 nmol/L。仅接受化疗的患者，新辅助化疗期间血清维生素D水平下降（中位数下降16 nmol/L，P = 0.003）。维生素D水平<50 nmol/L的患病率从基线时的38.3%增加到化疗后的55.9%。在总体人群中，基线和治疗结束时的维生素D水平与病理反应无关。未发现pCR与维生素D水平变化之间存在关联。
新辅助化疗后维生素D显著下降表明应监测维生素D水平，若维生素D水平下降，纠正可能有益于骨骼健康并可能改善乳腺癌结局。
