Tonyali Onder, Coskun Ugur, Yuksel Sinemis, Inanc Mevlude, Bal Oznur, Akman Tulay, Yazilitas Dogan, Ulas Arife, Kucukoner Mehmet, Aksoy Asude, Demirci Umut, Uysal Mukremin, Tanriverdi Ozgur, Gunaydin Yusuf, Sumbul Ahmet Taner, Yildiz Ramazan, Karaca Halit, Oksuzoglu Berna, Ciltas Aydin, Buyukberber Suleyman, Benekli Mustafa
Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
Breast. 2016 Feb;25:22-6. doi: 10.1016/j.breast.2015.11.006. Epub 2015 Dec 20.
The aim of this study was to determine risk factors for brain metastasis as the first site of disease recurrence in patients with HER2-positive early-stage breast cancer (EBC) who received adjuvant trastuzumab.
Medical records of 588 female patients who received 52-week adjuvant trastuzumab from 14 centers were evaluated. Cumulative incidence functions for brain metastasis as the first site of disease recurrence and the effect of covariates on brain metastasis were evaluated in a competing risk analysis and competing risks regression, respectively.
Median follow-up time was 36 months. Cumulative incidence of brain metastasis at 12 months and 24 months was 0.6% and 2%, respectively. HER2-enriched subtype (ER- and PR-) tumor (p = 0.001, RR: 3.4, 95% CI: 1.33-8.71) and stage 3 disease (p = 0.0032, RR: 9.39, 95% CI: 1.33-8.71) were significant risk factors for development of brain metastasis as the first site of recurrence.
In patients with HER2 positive EBC who received adjuvant trastuzumab, HER2-enriched subtype (ER- and PR-) tumor and stage 3 disease were associated with increased risk of brain metastasis as the first site of disease recurrence.
本研究旨在确定接受辅助曲妥珠单抗治疗的HER2阳性早期乳腺癌（EBC）患者疾病复发的首发部位为脑转移的危险因素。
评估了来自14个中心的588例接受52周辅助曲妥珠单抗治疗的女性患者的病历。分别在竞争风险分析和竞争风险回归中评估了疾病复发的首发部位为脑转移的累积发病率函数以及协变量对脑转移的影响。
中位随访时间为36个月。12个月和24个月时脑转移的累积发病率分别为0.6%和2%。HER2富集亚型（ER-和PR-）肿瘤（p = 0.001，RR：3.4，95%CI：1.33 - 8.71）和3期疾病（p = 0.0032，RR：9.39，95%CI：1.33 - 8.71）是疾病复发的首发部位为脑转移发生的显著危险因素。
在接受辅助曲妥珠单抗治疗的HER2阳性EBC患者中，HER2富集亚型（ER-和PR-）肿瘤和3期疾病与疾病复发的首发部位为脑转移的风险增加相关。
