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阿司匹林/抗血小板药物的使用可改善II期和III期三阴性乳腺癌患者的无病生存期,并降低远处转移风险。

Aspirin/antiplatelet agent use improves disease-free survival and reduces the risk of distant metastases in Stage II and III triple-negative breast cancer patients.

作者信息

Shiao J, Thomas K M, Rahimi A S, Rao R, Yan Jingsheng, Xie Xian-Jin, DaSilva M, Spangler A, Leitch M, Wooldridge R, Rivers A, Farr D, Haley B, Kim D W Nathan

机构信息

Department of Radiation Oncology, University of Texas Southwestern Medical Center, 5801 Forest Park Road, Dallas, TX, 75390-9183, USA.

Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

出版信息

Breast Cancer Res Treat. 2017 Feb;161(3):463-471. doi: 10.1007/s10549-016-4081-8. Epub 2016 Dec 22.

Abstract

PURPOSE

The objective is to define the therapeutic role of antiplatelet agents in a triple-negative breast cancer (TNBC) population.

METHODS

We performed retrospective analysis using the UTSW TNBC registry containing data from 222 Stage II-III TNBC patients treated between 1998 and 2016. Univariate analysis and multivariable logistic regression models were constructed to identify factors associated with disease-free survival (DFS), distant metastases rate (DMR), and overall survival outcomes. Antiplatelet drug use was determined by review of electronic medical records.

RESULTS

A total of 65 patients used antiplatelet (AP) agents, and 157 patients did not use AP agents. Median follow-up for AP and non-AP groups was 41.3 and 40.9 months, respectively. There was an improvement in the AP group compared with the control group in 5-year DFS (80.4% at 5 years compared with 62.3% in the control group, p = 0.04) and 5-year DMR (8.8 vs. 31.9%, p = 0.007). In multivariate analysis, AP use was found to be significantly associated with improvements in DFS and DMR.

CONCLUSIONS

We illustrate that antiplatelet agent use improves DMR and DFS among a stage II and III TNBC population despite our short follow-up evaluation. Longer follow-up evaluation will be required to determine additional outcome advantage for antiplatelet agent use. Our findings support consideration of investigation of antiplatelet therapy as an adjunctive therapy for TNBC at high risk for disease recurrence.

摘要

目的

本研究旨在明确抗血小板药物在三阴性乳腺癌(TNBC)人群中的治疗作用。

方法

我们使用UTSW TNBC登记数据库进行回顾性分析,该数据库包含了1998年至2016年间接受治疗的222例II - III期TNBC患者的数据。构建单因素分析和多变量逻辑回归模型,以确定与无病生存期(DFS)、远处转移率(DMR)和总生存结局相关的因素。通过查阅电子病历确定抗血小板药物的使用情况。

结果

共有65例患者使用抗血小板(AP)药物,157例患者未使用AP药物。AP组和非AP组的中位随访时间分别为41.3个月和40.9个月。与对照组相比,AP组的5年DFS(5年时为80.4%,对照组为62.3%,p = 0.04)和5年DMR(8.8%对31.9%,p = 0.007)有所改善。在多变量分析中,发现使用AP与DFS和DMR的改善显著相关。

结论

尽管我们的随访评估时间较短,但我们的研究表明,在II期和III期TNBC人群中,使用抗血小板药物可改善DMR和DFS。需要更长时间的随访评估来确定使用抗血小板药物的其他结局优势。我们的研究结果支持考虑将抗血小板治疗作为疾病复发高风险TNBC的辅助治疗进行研究。

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