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肥胖与乳腺癌转移发展及一线转移性化疗反应的相关性

Obesity Correlation With Metastases Development and Response to First-Line Metastatic Chemotherapy in Breast Cancer.

作者信息

Osman Mohammed A, Hennessy Bryan T

机构信息

Our Lady of Lourdes hospital, Drogheda, Co Louth, Ireland.

出版信息

Clin Med Insights Oncol. 2015 Nov 24;9:105-12. doi: 10.4137/CMO.S32812. eCollection 2015.

Abstract

STUDY OBJECTIVES

To compare breast cancer metastases between obese and nonobese women and to evaluate the effect of first-line metastatic chemotherapy in each group.

METHOD

A retrospective study was performed in an educational institute in Ireland. The study consisted of two parts: the first part was a comparative analysis of metastases development in obese (arm A) and nonobese patients (arm B). The second part was a comparison between both arms in relation to their response to first-line metastatic chemotherapy and their survival data.

RESULTS

Between 2009 and 2014, we reviewed 118 patients with metastatic breast cancer. All the patients fulfilled our inclusion criteria. In all, 48% of patients were obese and 52% were nonobese. There were no statistically significant differences between the two groups. For arms A and B, the median interval between initial cancer diagnosis and distant metastases development (distant metastases-free survival) was 5.8 versus 7.6 years, respectively (Pvalue 0.04). Earlier visceral (liver and lung) metastases were observed in obese compared to nonobese women (Pvalues were 0.05 and 0.04, respectively). The most commonly used chemotherapy was weekly paclitaxel. Our treatments showed significantly better treatment response and better survival results in nonobese women than in obese ones, who were premenopausal with performance state 2, pathological grade 3, and four or more positive lymph nodes.

CONCLUSION

Obesity is linked with visceral metastases development, especially lung and liver metastases. Furthermore, first-line metastatic chemotherapy achieved better results in nonobese patients.

摘要

研究目的

比较肥胖与非肥胖女性乳腺癌转移情况,并评估每组一线转移性化疗的效果。

方法

在爱尔兰的一所教育机构进行了一项回顾性研究。该研究包括两个部分:第一部分是对肥胖患者组(A组)和非肥胖患者组(B组)转移发展情况的比较分析。第二部分是比较两组对一线转移性化疗的反应及其生存数据。

结果

2009年至2014年期间,我们对118例转移性乳腺癌患者进行了回顾。所有患者均符合纳入标准。总体而言,48%的患者肥胖,52%的患者非肥胖。两组之间无统计学显著差异。对于A组和B组,初次癌症诊断与远处转移发生之间的中位间隔时间(无远处转移生存期)分别为5.8年和7.6年(P值为0.04)。与非肥胖女性相比,肥胖女性更早出现内脏(肝脏和肺部)转移(P值分别为0.05和0.04)。最常用的化疗药物是每周一次的紫杉醇。我们的治疗显示,非肥胖女性的治疗反应和生存结果明显优于肥胖女性,这些肥胖女性为绝经前,体能状态为2,病理分级为3,且有四个或更多阳性淋巴结。

结论

肥胖与内脏转移的发生有关,尤其是肺和肝转移。此外,一线转移性化疗在非肥胖患者中取得了更好的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bb3/4659439/16ea03bb734b/cmo-9-2015-105f1.jpg

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